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Arnison T, Evans B, Schrooten MGS, Persson J, Palermo TM. Adolescent Girls' Musculoskeletal Pain is More Affected by Insomnia Than Boys, and Through Different Psychological Pathways. THE JOURNAL OF PAIN 2024:104571. [PMID: 38763259 DOI: 10.1016/j.jpain.2024.104571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 05/13/2024] [Accepted: 05/14/2024] [Indexed: 05/21/2024]
Abstract
Prior research has established that insomnia is predictive of pain in adolescents and that psychological mechanisms have a crucial role in this relationship. Adolescent girls report more insomnia and pain than boys, yet little is known of gender differences in how insomnia influences pain. This study assessed gender differences in levels and trajectories of insomnia and pain during adolescence, and whether rumination and negative mood mediated the effect of insomnia on pain. Longitudinal survey data measured on 5 annual occasions (Nbaseline = 2,767) were analyzed in a multigroup longitudinal serial mediation model. A final model was generated with insomnia as the predictor, rumination and depressed mood as mediators, pain as the outcome, and gender as the grouping variable. The results showed that insomnia predicted pain in adolescents, with an effect 3.5 times larger in girls than boys. Depressed mood was the main mediator in boys. In girls, rumination was the only significant mediator. There were significant gender differences in the effects of insomnia on rumination and pain, and in the effects of rumination on depressed mood and pain, with stronger effects in girls. These results highlight that girls and boys should be considered separately when studying the relationship between insomnia and pain. PERSPECTIVE: Levels of insomnia and pain are progressively higher in adolescent girls than boys, across adolescence. The predictive strength of insomnia symptoms for future pain is 3.5 times greater in girls, with distinct gender-specific underlying pathways: rumination partially mediates this effect in girls, while depressed mood does so in boys.
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Affiliation(s)
- Tor Arnison
- Clinical Epidemiology and Biostatistics, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Örebro County, Sweden; School of Behavioural, Social and Legal Sciences, Örebro University, Örebro, Örebro County, Sweden.
| | - Brittany Evans
- School of Behavioural, Social and Legal Sciences, Örebro University, Örebro, Örebro County, Sweden
| | - Martien G S Schrooten
- School of Behavioural, Social and Legal Sciences, Örebro University, Örebro, Örebro County, Sweden
| | - Jonas Persson
- School of Behavioural, Social and Legal Sciences, Örebro University, Örebro, Örebro County, Sweden; Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Stockholm County, Sweden
| | - Tonya M Palermo
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington; Department of Anesthesiology, Pediatrics & Psychiatry, University of Washington School of Medicine, Seattle, Washington
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Türkarslan KK, Canel Çınarbaş D. Insomnia Severity Predicts Psychiatric Symptoms: A Cross-Sectional Study Investigating the Partial Mediations of Worry and Rumination. Psychiatry 2024; 87:179-193. [PMID: 38758524 DOI: 10.1080/00332747.2024.2347100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
OBJECTIVE Insomnia as a disorder on its own or as a symptom of other mental disorders can lead to significant distress and lower quality of life. By exacerbating negative affect and emotion dysregulation, poor sleep and insomnia can contribute to the initiation and maintenance of mental disorders. The aim of this cross-sectional study was to investigate the relationship between insomnia severity and overall psychiatric symptoms (anxiety, depression, obsessive-compulsive symptoms, somatization, phobic anxiety, hostility, interpersonal sensitivity, paranoid ideation, and psychoticism), and the mediational roles of worry and rumination in this relationship. METHOD The data was collected from a community sample of 1444 participants (females 69.39%, Mage = 27.95, SD = 9.37) who completed self-report measures of insomnia severity, worry, rumination, and psychiatric symptoms. The mediational roles of worry and rumination were tested with mediation analysis using the PROCESS Macro. RESULTS It was found that insomnia severity (β = 0.20, p < .001) significantly predicted psychiatric symptoms directly and via worry and rumination (β = 0.33, p < .001), meaning that worry and rumination partially mediated the relationship between insomnia severity and psychiatric symptoms. The findings were similar after controlling for smoking status, daily screen time, coffee consumption in the evening, weekly exercise frequency, and pre-sleep screen time. CONCLUSIONS Interventions targeting the reduction of insomnia severity and maladaptive emotion regulation strategies (e.g., worry and rumination), as well as the enhancement of adaptive emotion regulation strategies (e.g., positive refocusing and mindfulness), may alleviate the adverse effects of insomnia on psychiatric symptoms.
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Kutzer Y, Whitehead L, Quigley E, Stanley M. Changes in sleep effort mediate insomnia severity in older adults following online cognitive behavioural therapy. Psychogeriatrics 2024; 24:303-311. [PMID: 38168883 DOI: 10.1111/psyg.13074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 10/24/2023] [Accepted: 12/21/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND To examine treatment mechanisms of digitally delivered cognitive behavioural therapy for insomnia (CBT-I), this study assessed the mediating effects of dysfunctional beliefs, hyperarousal, locus of control, self-efficacy, sleep effort, and safety behaviours on self-reported insomnia severity in older adults before and following the completion of a self-guided, online CBT-I program. METHODS The baseline and follow-up measurements were completed by 62 older adults (55 female, 89%). This was a two-condition within-participant design. Mediation analysis using a parallel mediation model was conducted using the MEMORE macro for repeated measure designs. RESULTS Out of all the included mediator variables, only a reduction in sleep effort scores (0.88; SE 0.51; 95% CI 0.001-2.00) significantly mediated changes in insomnia severity scores following the intervention. Insomnia severity scores significantly reduced following the intervention (Mpre = 9.84, SD = 5.89, Mpost = 6.87, SD = 4.90); t(61) = 5.19, P = <0.001; d = 0.55 95% CI 0.38-0.93. CONCLUSIONS Sleep in older adults improved following digitally delivered CBT-I, and these changes were influenced by a reduction in sleep control efforts exerted by participants. These findings highlight possible treatment pathways of CBT-I. Further investigation of CBT-I as a strategy to prevent sleep problems is warranted. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN 12619001509156; http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378451.
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Affiliation(s)
- Yvonne Kutzer
- Edith Cowan University, Perth, Western Australia, Australia
| | - Lisa Whitehead
- Edith Cowan University, Perth, Western Australia, Australia
| | - Eimear Quigley
- Edith Cowan University, Perth, Western Australia, Australia
- ORS Group, Perth, Western Australia, Australia
| | - Mandy Stanley
- Edith Cowan University, Perth, Western Australia, Australia
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Küskens A, Stricker J, Hertrampf LS, Pietrowsky R, Gieselmann A. Perfectionism, perceived stress, and presleep arousal in insomnia: effects on sleep in a daily life study. J Clin Sleep Med 2024; 20:433-443. [PMID: 37942932 PMCID: PMC11019203 DOI: 10.5664/jcsm.10910] [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: 03/29/2023] [Revised: 11/06/2023] [Accepted: 11/07/2023] [Indexed: 11/10/2023]
Abstract
STUDY OBJECTIVES Perfectionism is considered a predisposing and maintaining factor for insomnia disorder. However, previous studies were predominantly based on retrospective self-reports of sleep and have yielded mixed results. Here, we investigated associations between perfectionism, daily stress levels, pre-sleep arousal, and actigraphic and sleep diary-derived sleep in insomnia using an experience sampling design. METHODS Individuals with insomnia (n = 63) reported their trait perfectionism levels and completed assessments on seven consecutive days. Momentary stress levels were reported on mobile phones at three semirandom time points each day. Presleep arousal levels were rated each morning for the previous night. Sleep onset latency, total sleep time, wake after sleep onset, and sleep efficiency were assessed prospectively using actigraphic watches and sleep diaries. RESULTS Perfectionism dimensions and daily stress levels did not predict self-reported or actigraphic sleep parameters. Higher levels of somatic and cognitive presleep arousal were robustly associated with indicators of poorer same-night sleep. The concern over mistakes and doubts dimension of perfectionism interacted with cognitive presleep arousal in predicting self-reported sleep parameters. In the presence of higher presleep arousal, participants with high concern over mistakes and doubts experienced shorter self-reported total sleep time and lower sleep efficiency (both Ps < .01) than on days with lower cognitive arousal. CONCLUSIONS Taken together, our results did not indicate an impact of heightened perfectionism levels on sleep in individuals with insomnia, based on prospective sleep assessments. However, our findings provide further evidence for the role of somatic and cognitive presleep arousal, potentially interacting with perfectionism, in the perpetuation of insomnia symptoms. CITATION Küskens A, Stricker J, Hertrampf LS, Pietrowsky R, Gieselmann A. Perfectionism, perceived stress, and presleep arousal in insomnia: effects on sleep in a daily life study. J Clin Sleep Med. 2024;20(3):433-443.
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Affiliation(s)
- Anna Küskens
- Department of Experimental Psychology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Johannes Stricker
- Department of Experimental Psychology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Luca Stefan Hertrampf
- Department of Experimental Psychology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Reinhard Pietrowsky
- Department of Experimental Psychology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Annika Gieselmann
- Department of Experimental Psychology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
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Hildebrand L, Huskey A, Dailey N, Jankowski S, Henderson-Arredondo K, Trapani C, Patel SI, Chen AYC, Chou YH, Killgore WDS. Transcranial Magnetic Stimulation of the Default Mode Network to Improve Sleep in Individuals With Insomnia Symptoms: Protocol for a Double-Blind Randomized Controlled Trial. JMIR Res Protoc 2024; 13:e51212. [PMID: 38277210 PMCID: PMC10858423 DOI: 10.2196/51212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 12/24/2023] [Accepted: 12/26/2023] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Cortical hyperarousal and ruminative thinking are common aspects of insomnia that have been linked with greater connectivity in the default mode network (DMN). Therefore, disrupting network activity within the DMN may reduce cortical and cognitive hyperarousal and facilitate better sleep. OBJECTIVE This trial aims to establish a novel, noninvasive method for treating insomnia through disruption of the DMN with repetitive transcranial magnetic stimulation, specifically with continuous theta burst stimulation (cTBS). This double-blind, pilot randomized controlled trial will assess the efficacy of repetitive transcranial magnetic stimulation as a novel, nonpharmacological approach to improve sleep through disruption of the DMN prior to sleep onset for individuals with insomnia. Primary outcome measures will include assessing changes in DMN functional connectivity before and after stimulation. METHODS A total of 20 participants between the ages of 18 to 50 years with reported sleep disturbances will be recruited as a part of the study. Participants will then conduct an in-person screening and follow-on enrollment visit. Eligible participants then conduct at-home actigraphic collection until their first in-residence overnight study visit. In a double-blind, counterbalanced, crossover study design, participants will receive a 40-second stimulation to the left inferior parietal lobule of the DMN during 2 separate overnight in-residence visits. Participants are randomized to the order in which they receive the active stimulation and sham stimulation. Study participants will undergo a prestimulation functional magnetic resonance imaging scan and a poststimulation functional magnetic resonance imaging scan prior to sleep for each overnight study visit. Sleep outcomes will be measured using clinical polysomnography. After their first in-residence study visit, participants conduct another at-home actigraphic collection before returning for their second in-residence overnight study visit. RESULTS Our study was funded in September 2020 by the Department of Defense (W81XWH2010173). We completed the enrollment of our target study population in the October 2022 and are currently working on neuroimaging processing and analysis. We aim to publish the results of our study by 2024. Primary neuroimaging outcome measures will be tested using independent components analysis, seed-to-voxel analyses, and region of interest to region of interest analyses. A repeated measures analysis of covariance (ANCOVA) will be used to assess the effects of active and sham stimulation on sleep variables. Additionally, we will correlate changes in functional connectivity to polysomnography-graded sleep. CONCLUSIONS The presently proposed cTBS protocol is aimed at establishing the initial research outcomes of the effects of a single burst of cTBS on disrupting the network connectivity of the DMN to improve sleep. If effective, future work could determine the most effective stimulation sites and administration schedules to optimize this potential intervention for sleep problems. TRIAL REGISTRATION ClinicalTrials.gov NCT04953559; https://clinicaltrials.gov/ct2/show/NCT04953559. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/51212.
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Affiliation(s)
- Lindsey Hildebrand
- Department of Psychiatry, University of Arizona, Tucson, AZ, United States
| | - Alisa Huskey
- Department of Psychiatry, University of Arizona, Tucson, AZ, United States
| | - Natalie Dailey
- Department of Psychiatry, University of Arizona, Tucson, AZ, United States
| | - Samantha Jankowski
- Department of Psychiatry, University of Arizona, Tucson, AZ, United States
| | | | | | - Salma Imran Patel
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Arizona, Tucson, AZ, United States
| | | | - Ying-Hui Chou
- Department of Psychology, University of Arizona, Tucson, AZ, United States
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Xiao H, Shen Y, Zhang W, Lin R. Applicability of the cognitive model of generalized anxiety disorder to adolescents' sleep quality: A cross-sectional and longitudinal analysis. Int J Clin Health Psychol 2023; 23:100406. [PMID: 37663041 PMCID: PMC10472235 DOI: 10.1016/j.ijchp.2023.100406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 08/21/2023] [Indexed: 09/05/2023] Open
Abstract
Background Poor sleep quality is a prevalent health issue among adolescents, and few studies have examined the variables affecting adolescents' sleep quality from the perspective of the co-occurrence of sleep issues and anxiety disorders. Therefore, the current study investigated whether the cognitive model of generalized anxiety disorder applies to adolescents' sleep quality. Method In Study 1, a total of 2042 adolescents were recruited and they completed questionnaires relating to worry, intolerance of uncertainty (IU), negative problem orientation (NPO), cognitive avoidance (CA), and sleep quality. In Study 2, a total of 379 adolescents participated in a six-month longitudinal survey to verify the model that was obtained in Study 1. Results Study 1 showed the modified cognitive model of generalized anxiety disorder can be applied to adolescents' sleep quality. Specifically, IU was a higher-order vulnerability factor that directly affected worry, and indirectly fostered worry via NPO and CA, where worry only mediated the relationships between IU, NPO, and sleep quality. However, CA exerted no independent effect on worry or sleep quality beyond the influences of IU and NPO, therefore, it dropped out of the final model. Study 2 partially confirmed the above model again from the longitudinal perspective. Conclusion The present study constructs a new model to explain adolescents' sleep quality, providing a foundation for future interventions.
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Affiliation(s)
- Huiwen Xiao
- School of Psychology, Fujian Normal University, Fuzhou 350117, China
- Department of Psychology, Renmin University of China, Beijing 100872, China
| | - Yilin Shen
- School of Psychology, Fujian Normal University, Fuzhou 350117, China
| | - Weizhong Zhang
- School of Psychology, Fujian Normal University, Fuzhou 350117, China
| | - Rongmao Lin
- School of Psychology, Fujian Normal University, Fuzhou 350117, China
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Zemla K, Sedek G, Wróbel K, Postepski F, Wojcik GM. Investigating the Impact of Guided Imagery on Stress, Brain Functions, and Attention: A Randomized Trial. SENSORS (BASEL, SWITZERLAND) 2023; 23:6210. [PMID: 37448060 PMCID: PMC10346678 DOI: 10.3390/s23136210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 06/28/2023] [Accepted: 07/04/2023] [Indexed: 07/15/2023]
Abstract
The aim of this study was to investigate the potential impact of guided imagery (GI) on attentional control and cognitive performance and to explore the relationship between guided imagery, stress reduction, alpha brainwave activity, and attentional control using common cognitive performance tests. Executive function was assessed through the use of attentional control tests, including the anti-saccade, Stroop, and Go/No-go tasks. Participants underwent a guided imagery session while their brainwave activity was measured, followed by attentional control tests. The study's outcomes provide fresh insights into the influence of guided imagery on brain wave activity, particularly in terms of attentional control. The findings suggest that guided imagery has the potential to enhance attentional control by augmenting the alpha power and reducing stress levels. Given the limited existing research on the specific impact of guided imagery on attention control, the study's findings carry notable significance.
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Affiliation(s)
- Katarzyna Zemla
- Institute of Psychology, SWPS University of Social Sciences and Humanities, 03-815 Warsaw, Poland; (K.Z.)
| | - Grzegorz Sedek
- Institute of Psychology, SWPS University of Social Sciences and Humanities, 03-815 Warsaw, Poland; (K.Z.)
| | - Krzysztof Wróbel
- Department of Neuroinformatics and Biomedical Engineering, Institute of Computer Science, Maria Curie-Sklodowska University, 20-033 Lublin, Poland (F.P.)
| | - Filip Postepski
- Department of Neuroinformatics and Biomedical Engineering, Institute of Computer Science, Maria Curie-Sklodowska University, 20-033 Lublin, Poland (F.P.)
| | - Grzegorz M. Wojcik
- Department of Neuroinformatics and Biomedical Engineering, Institute of Computer Science, Maria Curie-Sklodowska University, 20-033 Lublin, Poland (F.P.)
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Erving CL, Zajdel R, McKinnon II, Van Dyke ME, Murden RJ, Johnson DA, Moore RH, Lewis TT. Gendered Racial Microaggressions and Black Women's Sleep Health. SOCIAL PSYCHOLOGY QUARTERLY 2023; 86:107-129. [PMID: 38371316 PMCID: PMC10869115 DOI: 10.1177/01902725221136139] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
Gendered racial microaggressions reflect historical and contemporary gendered racism that Black women encounter. Although gendered racial microaggressions are related to psychological outcomes, it is unclear if such experiences are related to sleep health. Moreover, the health effects of gendered racial microaggressions dimensions are rarely investigated. Using a cohort of Black women (N = 400), this study employs an intracategorical intersectional approach to (1) investigate the association between gendered racial microaggressions and sleep health, (2) assess whether gendered racial microaggressions dimensions are related to sleep health, and (3) examine whether the gendered racial microaggressions-sleep health association persists after accounting for depressive symptoms and worry. Gendered racial microaggressions were associated with poor sleep quality overall and four specific domains: subjective sleep quality, latency, disturbance, and daytime sleepiness. Two gendered racial microaggressions dimensions were especially detrimental for sleep: assumptions of beauty/sexual objectification and feeling silenced and marginalized. After accounting for mental health, the effect of gendered racial microaggressions on sleep was reduced by 47 percent. Future research implications are discussed.
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Affiliation(s)
| | - Rachel Zajdel
- National Heart, Lung, and Blood Institute, Bethesda, MD, USA
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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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Meaklim H, Junge MF, Varma P, Finck WA, Jackson ML. Beyond Stress: Altered Sleep-Wake Patterns are a Key Behavioral Risk Factor for Acute Insomnia During Times of Crisis. Behav Sleep Med 2023; 21:208-225. [PMID: 35604338 DOI: 10.1080/15402002.2022.2074996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
BACKGROUND Stress is a common precipitant of acute insomnia; however, reducing stress during times of crisis is challenging. This study aimed to determine which modifiable factors, beyond stress, were associated with acute insomnia during a major crisis, the COVID-19 pandemic. PARTICIPANTS/METHODS A global online survey assessed sleep/circadian, stress, mental health, and lifestyle factors between April-May 2020. Logistic regression models analyzed data from 1319 participants (578 acute insomnia, 731 good sleepers), adjusted for demographic differences. RESULTS Perceived stress was a significant predictor of acute insomnia during the pandemic (OR 1.23, 95% CI1.19-1.27). After adjusting for stress, individuals who altered their sleep-wake patterns (OR 3.36, CI 2.00-5.67) or increased technology use before bed (OR 3.13, CI 1.13-8.65) were at increased risk of acute insomnia. Other sleep factors associated with acute insomnia included changes in dreams/nightmares (OR 2.08, CI 1.32-3.27), increased sleep effort (OR 1.99, CI1.71-2.31) and cognitive pre-sleep arousal (OR 1.18, CI 1.11-1.24). For pandemic factors, worry about contracting COVID-19 (OR 3.08, CI 1.18-8.07) and stringent government COVID-19 restrictions (OR 1.12, CI =1.07-1.18) were associated with acute insomnia. Anxiety (OR 1.02, CI 1.01-1.05) and depressive (OR 1.29, CI 1.22-1.37) symptoms were also risk factors. A final hierarchical regression model revealed that after accounting for stress, altered sleep-wake patterns were a key behavioral predictor of acute insomnia (OR 2.60, CI 1.68-5.81). CONCLUSION Beyond stress, altered sleep-wake patterns are a key risk factor for acute insomnia. Modifiable behaviors such as maintaining regular sleep-wake patterns appear vital for sleeping well in times of crisis.
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Affiliation(s)
- Hailey Meaklim
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Moira F Junge
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia.,The Sleep Health Foundation, Blacktown, New South Wales, Australia
| | - Prerna Varma
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Wendy A Finck
- Faculty of Education, Monash University, Clayton, Victoria, Australia
| | - Melinda L Jackson
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
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Grove JL, Carlson SE, Parkhurst KA, O’Neill JC, Smith TW. Nonsuicidal self-injury, sleep quality, and shame response to a laboratory stress task. J Clin Psychol 2023; 79:871-885. [PMID: 36223526 PMCID: PMC9925399 DOI: 10.1002/jclp.23450] [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: 02/17/2022] [Revised: 07/26/2022] [Accepted: 09/30/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Nonsuicidal self-injury (NSSI) frequently functions to regulate shame-based emotions and cognitions in the context of interpersonal stress. The present study sought to examine how sleep quality (SQ) may influence this process in a laboratory setting. METHODS Participants included 72 adults (Mage = 24.28; 36 with a lifetime history of NSSI) who completed a self-report measure of prior month SQ and engaged in a modified Trier social stress task (TSST). State shame ratings were collected immediately before and following the TSST, as well as 5 min post-TSST, to allow for the measurement of shame reactivity and recovery. RESULTS No significant results emerged for NSSI history and SQ as statistical predictors of shame reactivity. However, NSSI history was significantly associated with heightened shame intensity during the recovery period of the task, and this was moderated by SQ. Simple slopes analyses revealed a conditional effect whereby poorer SQ (1SD above the mean) was associated with greater intensity of shame during recovery, but only for those with a history of NSSI. CONCLUSION Poor SQ may contribute to worrisome emotional responses to daytime stressors in those at risk for NSSI.
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Tagay Ö, Voltan Acar N, Cırcır O. The relationships among ruminative thoughts, Gestalt contact disturbances and unfinished business. CURRENT PSYCHOLOGY 2023. [DOI: 10.1007/s12144-023-04335-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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Chang X, Guo C, Zhou H, Liu L. Impact of rumination on sleep quality among patients with non‑alcoholic fatty liver disease: a moderated mediation model of anxiety symptoms and resilience. BMC Psychiatry 2023; 23:84. [PMID: 36732707 PMCID: PMC9893673 DOI: 10.1186/s12888-023-04572-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 01/27/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Poor sleep raises the risk of non-alcoholic fatty liver disease (NAFLD) and hastens disease progression. It is critical to figure out what factors impact the sleep quality of NAFLD patients. The present study aimed to investigate the role of anxiety symptoms in accounting for the impact of rumination on sleep quality and the moderating role of resilience on the associations of rumination with anxiety symptoms and sleep quality. METHODS In the cross-sectional study, 285 NAFLD patients completed the Chinese version of the Pittsburgh Sleep Quality Index, the Ruminative Responses Scale, the Generalized Anxiety Disorder 7-item scale, and the 14-item Resilience Scale to measure sleep quality, rumination (including brooding and reflection), anxiety symptoms, and resilience, respectively. The PROCESS macro for SPSS v4.0 procedure was applied to perform moderated mediation analysis. RESULTS The roles of anxiety symptoms in accounting for the positive associations of brooding, reflection and rumination with poor sleep quality were revealed. It was found that there was a significant moderating role of resilience on the positive associations of brooding, reflection and rumination with anxiety symptoms, which were gradually reduced as resilience increased. The direct associations between brooding, reflection and rumination and poor sleep quality were not significantly moderated by resilience. Thus, a moderated mediation model involving anxiety symptoms and resilience for explaining the impact of rumination on poor sleep quality was supported among patients with NAFLD. CONCLUSIONS Rumination (including brooding and reflection) could be positively related to poor sleep quality, and anxiety symptoms had a significant role in accounting for the relationship among patients with NAFLD. Resilience showed a moderating role that could attenuate the positive association between rumination and anxiety symptoms. Interventions aimed at alleviating rumination, reducing anxiety symptoms, and enhancing resilience could improve the sleep quality of NAFLD patients.
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Affiliation(s)
- Xiaolin Chang
- grid.412636.40000 0004 1757 9485Outpatient Service By Famous Specialists, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Chenxi Guo
- grid.412636.40000 0004 1757 9485Department of Clinical Nutrition, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Heng Zhou
- Department of Surgical Oncology and General Surgery, The First Affiliated Hospital of China Medical University, Key Laboratory of Precision Diagnosis and Treatment of Gastrointestinal Tumors (China Medical University), Ministry of Education, Shenyang, China. .,Department of Anesthesiology, The First Affiliated Hospital of China Medical University, No. 155 Nanjing Bei Street, Heping District, Shenyang, 110001, Liaoning, China.
| | - Li Liu
- Department of Social Medicine, School of Health Management, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning, China.
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14
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Power CJ, Fox JL, Teramoto M, Scanlan AT. Sleep Patterns Fluctuate Following Training and Games across the Season in a Semi-Professional, Female Basketball Team. Brain Sci 2023; 13:brainsci13020238. [PMID: 36831781 PMCID: PMC9954585 DOI: 10.3390/brainsci13020238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/24/2023] [Accepted: 01/26/2023] [Indexed: 02/04/2023] Open
Abstract
Quantifying athlete sleep patterns may inform development of optimal training schedules and sleep strategies, considering the competitive challenges faced across the season. Therefore, this study comprehensively quantified the sleep patterns of a female basketball team and examined variations in sleep between nights. Seven semi-professional, female basketball players had their sleep monitored using wrist-worn activity monitors and perceptual ratings during a 13-week in-season. Sleep variables were compared between different nights (control nights, training nights, training nights before games, nights before games, non-congested game nights, and congested game nights), using generalized linear mixed models, as well as Cohen's d and odds ratios as effect sizes. Players experienced less sleep on training nights before games compared to control nights, training nights, nights before games, and congested game nights (p < 0.05, d = 0.43-0.69). Players also exhibited later sleep onset times on non-congested game nights compared to control nights (p = 0.01, d = 0.68), and earlier sleep offset times following training nights before games compared to all other nights (p < 0.01, d = 0.74-0.79). Moreover, the odds of players attaining better perceived sleep quality was 88% lower on congested game nights than on nights before games (p < 0.001). While players in this study attained an adequate sleep duration (7.3 ± 0.3 h) and efficiency (85 ± 2%) on average across the in-season, they were susceptible to poor sleep on training nights before games and following games. Although limited to a team-based case series design, these findings suggest basketball coaches may need to reconsider scheduling team-based, on-court training sessions on nights prior to games and consider implementing suitable psychological and recovery strategies around games to optimize player sleep.
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Affiliation(s)
- Cody J. Power
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD 4701, Australia
- Correspondence:
| | - Jordan L. Fox
- Rural Clinical School, The University of Queensland, Rockhampton, QLD 4700, Australia
| | - Masaru Teramoto
- Department of Physical Medicine and Rehabilitation, University of Utah, Salt Lake City, UT 84108, USA
| | - Aaron T. Scanlan
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD 4701, Australia
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15
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Niu X, Snyder HR. The role of maladaptive emotion regulation in the bidirectional relation between sleep and depression in college students during the COVID-19 pandemic. ANXIETY, STRESS, AND COPING 2023; 36:83-96. [PMID: 35536737 DOI: 10.1080/10615806.2022.2073441] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Background: Emotion regulation deficits are an outcome and risk factor for both insomnia and depression, suggesting that maladaptive emotion regulation might in part explain the bi-directional links between sleep and depression. The current study tests this hypothesis during the COVID-19 pandemic in emerging adult undergraduate students, a high-risk population for both depression and sleep disturbance.Methods: A sample of 154 undergraduate students completed a series of online questionnaires bi-weekly on sleep, depression, and emotion regulation strategies across eight weeks during the early days of the COVID-19 pandemic (April 2nd to June 27th, 2020).Results: Sleep disturbance and depression prospectively predicted one another across eight weeks, and both directions were mediated by maladaptive emotion regulation. However, sleep and depression failed to predict change in one another controlling for baseline measures, directly or via emotion regulation.Conclusions: The results suggest that maladaptive emotion regulation is a potential mechanism through which sleep disturbance and depression help maintain high levels of one another in college students during the COVID-19 pandemic. Therefore, emotion regulation deficits are potentially an important target for interventions to interrupt the sleep disturbance-depression cycle.
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Affiliation(s)
- Xinran Niu
- Department of Psychology, Brandeis University, Waltham, MA, USA
| | - Hannah R Snyder
- Department of Psychology, Brandeis University, Waltham, MA, USA
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16
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McKinnon II, Johnson DA, Murden RJ, Erving CL, Parker R, Van Dyke ME, Vaccarino V, Booker B, Moore RH, Lewis TT. Extreme racism-related events and poor sleep in African-American women. Soc Sci Med 2023; 316:115623. [PMID: 36581549 DOI: 10.1016/j.socscimed.2022.115623] [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] [Indexed: 12/28/2022]
Abstract
RATIONALE Much of the research linking racism-related stressors to poor health has focused on fairly non-violent forms of racism that directly impact individuals under study. Exposure to particularly extreme and/or violent racist events are increasingly visible via smartphone recordings and social media, with consistent anecdotal reports of the effects of seeing and hearing about these events on sleep among minorities who racially identify with the victims. OBJECTIVE This study examines whether exposure to direct and vicarious racism-related events (RREs), including more extreme events, are associated with sleep quality. Additionally, we examine effects of less and more violent direct RREs and vicarious RREs witnessed in person and via social media. METHODS Among 422 African-American women, we assessed exposure to RREs using a modified version of the Race-Related Events Scale and assessed sleep quality using the Pittsburgh Sleep Quality Index (PSQI). Linear regression analyses were used to model continuous global sleep. RESULTS Direct (β = 0.24 [95% CI: 0.13, 0.35]) RREs were associated with worse continuous global sleep quality scores in analyses adjusted for sociodemographics and risk factors for poor sleep. More violent direct RREs (β = 0.59 [95% CI: 0.30, 0.89]) had stronger associations with poor sleep quality than less violent direct RREs (β = 0.25 [95% CI: 0.11, 0.40]). Vicarious RREs overall (β = 0.04 [95% CI: 0.14, 0.21]) and those witnessed via social media (β = -0.07 [95% CI: 0.29, 0.14]) were not associated with global sleep quality; conversely, vicarious RREs witnessed in person were (β = 0.52 [95% CI: 0.21, 0.83]). CONCLUSION Extreme, direct experiences of racism, particularly those that are violent in nature, are associated with poor sleep quality. However, extreme vicarious experiences are not-- unless witnessed in person.
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Affiliation(s)
- Izraelle I McKinnon
- Department of Epidemiology (I.I.M., D.A.J., M.E.V.D., V.V., T.T.L.), Emory University, Rollins School of Public Health, Atlanta, GA, 30322, USA
| | - Dayna A Johnson
- Department of Epidemiology (I.I.M., D.A.J., M.E.V.D., V.V., T.T.L.), Emory University, Rollins School of Public Health, Atlanta, GA, 30322, USA
| | - Raphiel J Murden
- Department of Biostatistics (R.J.M., R.P.), Emory University, Rollins School of Public Health, Atlanta, GA, 30322, USA
| | - Christy L Erving
- Vanderbilt University (C.L.E.), Department of Sociology, 2301 Vanderbilt Place, 201E Garland Hall, Nashville, TN, 37235-1811, USA
| | - Rachel Parker
- Department of Biostatistics (R.J.M., R.P.), Emory University, Rollins School of Public Health, Atlanta, GA, 30322, USA
| | - Miriam E Van Dyke
- Department of Epidemiology (I.I.M., D.A.J., M.E.V.D., V.V., T.T.L.), Emory University, Rollins School of Public Health, Atlanta, GA, 30322, USA
| | - Viola Vaccarino
- Department of Epidemiology (I.I.M., D.A.J., M.E.V.D., V.V., T.T.L.), Emory University, Rollins School of Public Health, Atlanta, GA, 30322, USA; From the Division of Cardiology, Department of Medicine (V.V.), Emory University, School of Medicine, Atlanta, GA, 30322, USA
| | - Bianca Booker
- Department of Epidemiology (I.I.M., D.A.J., M.E.V.D., V.V., T.T.L.), Emory University, Rollins School of Public Health, Atlanta, GA, 30322, USA
| | - Renee H Moore
- Department of Epidemiology and Biostatistics (R.H.M), Drexel University, Dornsife School of Public Health, Philadelphia, PA, 19104, USA
| | - Tené T Lewis
- Department of Epidemiology (I.I.M., D.A.J., M.E.V.D., V.V., T.T.L.), Emory University, Rollins School of Public Health, Atlanta, GA, 30322, USA.
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17
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Habibi Asgarabad M, Doos Ali Vand H, Salehi Yegaei P, Hooman F, Ahmadi R, Baglioni C, Moradi S. The contribution of transdiagnostic vulnerability factors in patients with chronic insomnia. Front Psychiatry 2023; 14:1162729. [PMID: 37077275 PMCID: PMC10106755 DOI: 10.3389/fpsyt.2023.1162729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 03/14/2023] [Indexed: 04/21/2023] Open
Abstract
Introduction Various transdiagnostic factors have been associated with insomnia severity. The current study aimed to predict insomnia severity based on a group of transdiagnostic factors including neuroticism, emotion regulation, perfectionism, psychological inflexibility, anxiety sensitivity, and repetitive negative thinking after controlling for depression/anxiety symptoms and demographic characteristics. Methods Two hundred patients with chronic insomnia disorder were recruited from a sleep disorder clinic. Participants completed the Insomnia Severity Index (ISI), Clinical Perfectionism Questionnaire (CPQ), Acceptance and Action Questionnaire-II (AAQ-II), Anxiety Sensitivity Index-3 (ASI-3), Repetitive Thinking Questionnaire (RTQ-10), Big Five Inventory (BFI-10), Emotion Regulation Questionnaire (ERQ), and Depression Anxiety Stress Scale (DASS-21). Results After controlling for the confounding variables (depression/anxiety symptoms and demographic characteristics), hierarchical multiple linear regression suggested the significant association of neuroticism (BFI), cognitive reappraisal (ERQ), personal standards (CPQ), evaluative concerns (CPQ), physical concerns (ASI), cognitive concerns (ASI), and repetitive negative thinking (RTQ) with insomnia severity. Discussion The findings support the role of transdiagnostic factors, especially physical concerns, repetitive negative thinking, and neuroticism in chronic insomnia. Future research using longitudinal designs is required to verify the causal status of transdiagnostic variables.
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Affiliation(s)
- Mojtaba Habibi Asgarabad
- Health Promotion Research Center, Iran University of Medical Science, Tehran, Iran
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Health Psychology, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
- Positive Youth Development Lab, Human Development & Family Sciences, Texas Tech University, Texas, TX, United States
- Center of Excellence in Cognitive Neuropsychology, Institute for Cognitive and Brain Sciences, Shahid Beheshti University, Tehran, Iran
| | - Hoda Doos Ali Vand
- Department of Clinical Psychology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Pardis Salehi Yegaei
- Health Promotion Research Center, Iran University of Medical Science, Tehran, Iran
| | - Farzaneh Hooman
- Department of Psychology, Ahvaz Branch, Islamic Azad University, Ahvaz, Iran
| | - Reza Ahmadi
- Health Promotion Research Center, Iran University of Medical Science, Tehran, Iran
- Department of Clinical Psychology, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Chiara Baglioni
- Human Sciences Department, University of Rome Guglielmo Marconi Rome, Rome, Italy
- Department of Psychiatry and Psychotherapy, Medical Faculty, University of Freiburg, Freiburg, Germany
| | - Shahram Moradi
- Department of Health, Social and Welfare Studies, Faculty of Health and Social Sciences, University of South-Eastern Norway, Porsgrunn, Norway
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18
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Nowakowska-Domagała K, Juraś-Darowny M, Pietras T, Stecz P, Mokros Ł. Chronotype and poor sleep quality in young adults - a pilot study on the role of rumination. Sleep Med 2022; 100:206-211. [PMID: 36115139 DOI: 10.1016/j.sleep.2022.08.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 08/12/2022] [Accepted: 08/18/2022] [Indexed: 01/12/2023]
Abstract
BACKGROUND Eveningness has been associated with poor sleep quality and depression. However, chronotype has also been shown to be a multidimensional construct, not limited to a merely morningness-eveningness orientation. It has also been proposed that other factors may also mediate the relationship between chronotype and its mental health sequelae. This pilot study explores the role of rumination as a mediator between chronotype and sleep quality, chronotype and depressive symptoms. METHODS A sample of 144 participants completed The Morningness-Eveningness-Stability-Scale Improved (MESSi), Pittsburgh Sleep Quality Index (PSQI), Rumination-Reflection Questionnaire (RRQ) and Center for Epidemiologic Studies Depression Scale (CES-D)). The results were tested using Spearman's rank correlation coefficient, multiple linear regression and the Sobel test. RESULTS Rumination was linked to poor sleep quality and increased depression. Morning affect and Distinctness (i.e. rigidity, or the subjective amplitude of the circadian rhythm) correlated with rumination. Rumination was a partial mediator of the associations between Morning Affect and sleep quality, Morning Affect and depression. CONCLUSIONS Rumination may play a role in the association between chronotype (particularly Morning Affect and Distinction) and sleep quality and depression. The recognition of this association might serve as a basis for clinical psychoeducational and therapeutic programs targeting both adjustment of the circadian rhythm and rumination as a psychopathological sign.
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Affiliation(s)
| | | | - Tadeusz Pietras
- II-nd Psychiatry Clinic, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Patryk Stecz
- Institute of Psychology, Faculty of Educational Sciences, University of Lodz, Lodz, Poland
| | - Łukasz Mokros
- Department of Clinical Pharmacology, Medical University of Lodz, Lodz, Poland
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19
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Cohen A, Szepsenwol O, Haimov I. Insomnia Severity Mediates the Association between COVID-19 Related Anxiety and Increase in Tobacco Smoking During the COVID-19 Pandemic among Adults. Behav Sleep Med 2022:1-12. [PMID: 36421026 DOI: 10.1080/15402002.2022.2147934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Examining the associations of COVID-19 related anxiety and insomnia with increased smoking following the outbreak of the COVID-19 pandemic, and investigating whether increased insomnia severity mediates the association between COVID-19 related anxiety and increased smoking. METHODS 598 participants, aged 18-40, out of whom 140 self-identified as smokers, completed online questionnaires during the third wave of the COVID-19 pandemic. Measures included two items assessing COVID-19 related anxiety, the Pittsburgh Sleep Quality Index, and the Insomnia Severity Index, which included a pre-pandemic retrospective report. RESULTS Compared with nonsmokers, smokers reported lower sleep quality and more severe symptoms of insomnia. Among smokers, more severe symptoms of insomnia were associated with greater odds of increased smoking during the COVID-19 outbreak. COVID-19 related anxiety was indirectly associated with greater odds of increased smoking through greater insomnia severity during the COVID-19 outbreak, after controlling for pre-pandemic levels of insomnia. CONCLUSIONS Smokers experienced more sleep difficulties during the COVID-19 pandemic than nonsmokers. The results also lend support to the suggestion that anxiety, such that was experienced during the COVID-19 pandemic, may lead to further exacerbation of sleep difficulties, leading in turn to increase in smoking. These findings have important clinical implications that may be particularly relevant to attempts to minimize smoking during stressful circumstances.
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Affiliation(s)
- Ami Cohen
- Department of Psychology and the Center for Psychobiological Research, The Max-Stern Yezreel Valley College, Israel
| | - Ohad Szepsenwol
- Department of Education and Educational Counseling and the Center for Psychobiological Research, The Max-Stern Yezreel Valley College, Israel
| | - Iris Haimov
- Department of Psychology and the Center for Psychobiological Research, The Max-Stern Yezreel Valley College, Israel
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20
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Zagaria A, Ottaviani C, Lombardo C, Ballesio A. Perseverative Cognition as a Mediator Between Perceived Stress and Sleep Disturbance: A Structural Equation Modeling Meta-analysis (meta-SEM). Ann Behav Med 2022; 57:463-471. [DOI: 10.1093/abm/kaac064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Abstract
Background
According to the perseverative cognition (PC) hypothesis, the repetitive chronic activation of the cognitive representations of stressors are associated with a concomitant prolonged and sustained physiological stress response, including sleep disruption.
Purpose
We conducted a systematic review and structural equation modeling meta-analysis (meta-SEM) on PC as mediator of the association between perceived stress and subjective sleep disturbance (i.e., difficulties falling asleep or maintaining sleep).
Methods
PubMed, Scopus, Medline, CINAHL, and PsycInfo were searched up to September 2021. To test mediation, only longitudinal studies assessing the predictor (perceived stress) at T0, the mediator (PC) at T1, and the outcome (sleep disturbance) at T2, were eligible.
Results
Findings on 3,733 individuals (k = 8) showed a significant component effect of perceived stress on PC (β = 0.340, p < .001), which in turn was related to sleep disturbance (β = 0.258, p < .001). The direct effect of stress on sleep disturbance was significant (β = 0.133, p < .001). Lastly, the indirect effect between stress and sleep disturbance via PC supported the mediation hypothesis (β = 0.09, 95% CI 0.078–0.100). The mediation path remained significant (β = 0.03, 95% CI 0.020–0.036) after adjusting for baseline sleep disturbance. Further leave-one-out sensitivity and control analyses confirmed that all direct and indirect effects were not driven by any single study included in the meta-analysis, as well as their robustness when controlling for sex and age, respectively.
Conclusions
Overall, results of this meta-analysis indicate that PC may be one of the mechanisms explaining how perceived stressful experiences lead to subjective sleep disturbance.
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Affiliation(s)
- Andrea Zagaria
- Department of Psychology, Sapienza University of Rome , Rome , Italy
| | | | - Caterina Lombardo
- Department of Psychology, Sapienza University of Rome , Rome , Italy
| | - Andrea Ballesio
- Department of Psychology, Sapienza University of Rome , Rome , Italy
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21
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Lin RM, Xiong XX, Shen YL, Lin N, Chen YP. The heterogeneity of negative problem orientation in Chinese adolescents: A latent profile analysis. Front Psychol 2022; 13:1012455. [PMID: 36275308 PMCID: PMC9583661 DOI: 10.3389/fpsyg.2022.1012455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 09/07/2022] [Indexed: 11/26/2022] Open
Abstract
Negative problem orientation (NPO) has become an essential construct for comprehending social problem-solving deficits. However, the heterogeneity of NPO has not yet been explored. With a sample of Chinese adolescents (N = 2,174), four latent profiles were identified as lower NPO, moderate NPO, self-inefficacy and negative outcome expectancy (SI&NOE), and dysfunctional NPO. Compared to the lower NPO and moderate NPO, a greater percentage of boys in the SI&NOE and dysfunctional NPO profiles than were girls. In addition, lower grades and younger adolescents tended to engage in the moderate NPO and SI&NOE profiles. The dysfunctional NPO reported higher levels of worry, depressive symptoms, anxiety, and stress, and worse sleep quality than the other profiles. The implications of these findings are discussed herein.
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Affiliation(s)
- Rong-Mao Lin
- School of Psychology, Fujian Normal University, Fuzhou, Fujian, China
- *Correspondence: Rong-Mao Lin,
| | - Xia-Xin Xiong
- School of Psychology, Fujian Normal University, Fuzhou, Fujian, China
| | - Yi-Lin Shen
- School of Psychology, Fujian Normal University, Fuzhou, Fujian, China
| | - Nan Lin
- School of Psychology, Fujian Normal University, Fuzhou, Fujian, China
| | - Yan-Ping Chen
- School of Psychology, Fujian Normal University, Fuzhou, Fujian, China
- Department of Social Psychology, University of Groningen, Groningen, Netherlands
- Yan-Ping Chen,
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22
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Extreme racism-related events and poor sleep in African-American women. Soc Sci Med 2022; 310:115269. [PMID: 36041238 PMCID: PMC9598673 DOI: 10.1016/j.socscimed.2022.115269] [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] [Received: 11/04/2021] [Revised: 07/23/2022] [Accepted: 08/04/2022] [Indexed: 11/20/2022]
Abstract
RATIONALE Much of the research linking racism-related stressors to poor health has focused on fairly non-violent forms of racism that directly impact individuals under study. Exposure to particularly extreme and/or violent racist events are increasingly visible via smartphone recordings and social media, with consistent anecdotal reports of the effects of seeing and hearing about these events on sleep among minorities who racially identify with the victims. OBJECTIVE This study examines whether exposure to direct and vicarious racism-related events (RREs), including more extreme events, are associated with sleep quality. Additionally, we examine effects of less and more violent direct RREs and vicarious RREs witnessed in person and via social media. METHODS Among 422 African-American women, we assessed exposure to RREs using a modified version of the Race-Related Events Scale and assessed sleep quality using the Pittsburgh Sleep Quality Index (PSQI). Linear regression analyses were used to model continuous global sleep. RESULTS Direct (β = 0.24 [95% CI: 0.13, 0.35]) RREs were associated with worse continuous global sleep quality scores in analyses adjusted for sociodemographics and risk factors for poor sleep. More violent direct RREs (β = 0.59 [95% CI: 0.30, 0.89]) had stronger associations with poor sleep quality than less violent direct RREs (β = 0.25 [95% CI: 0.11, 0.40]). Vicarious RREs overall (β = 0.04 [95% CI: 0.14, 0.21]) and those witnessed via social media (β = -0.07 [95% CI: 0.29, 0.14]) were not associated with global sleep quality; conversely, vicarious RREs witnessed in person were (β = 0.52 [95% CI: 0.21, 0.83]). CONCLUSION Extreme, direct experiences of racism, particularly those that are violent in nature, are associated with poor sleep quality. However, extreme vicarious experiences are not-- unless witnessed in person.
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23
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Almeida IM, Slavish DC, Rafiuddin HS, Contractor AA. COVID‐19 related distress and sleep health among trauma‐exposed South Asians: Does generational status matter? Stress Health 2022; 39:335-346. [PMID: 35927977 PMCID: PMC9538516 DOI: 10.1002/smi.3184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 05/13/2022] [Accepted: 07/19/2022] [Indexed: 11/08/2022]
Abstract
The COVID-19 pandemic has resulted in substantial changes in individual and socio-economic factors that may negatively impact sleep health. We examined associations between COVID-19 related distress and sleep among trauma-exposed South Asian adults in the United States. Since a health advantage among foreign-born individuals has been previously noted in the literature (the 'immigrant paradox'), we also explored if generational status (number of generations one's family has been in the U.S.) moderated associations between COVID-19 related distress and sleep health. Participants were 196 trauma-exposed South Asian adults residing in the U.S. (54% male, 63% U.S.-born citizens, average age = 34.51 years), who completed measures of generational status, COVID-19 related distress, trauma exposure, sleep-related impairment (SRI), and sleep disturbances. Greater COVID-19 distress was associated with more sleep disturbances (b = 0.15, p < 0.001) and SRI (b = 0.24, p < 0.001). Generational status was not associated with sleep, nor did it modify associations between COVID-19 distress and sleep. Findings highlight the potential importance of developing interventions to reduce stress and sleep difficulties during the pandemic. Our results did not support the immigration paradox. Future studies are needed to better understand the role of generational status on sleep health across immigrant subgroups.
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24
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Bidirectional Associations between Daily PTSD Symptoms and Sleep Disturbances: A Systematic Review. Sleep Med Rev 2022; 63:101623. [DOI: 10.1016/j.smrv.2022.101623] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/14/2022] [Accepted: 03/03/2022] [Indexed: 11/24/2022]
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25
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Beck J, Loretz E, Rasch B. Stress dynamically reduces sleep depth: temporal proximity to the stressor is crucial. Cereb Cortex 2022; 33:96-113. [PMID: 35196708 PMCID: PMC9758584 DOI: 10.1093/cercor/bhac055] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 01/22/2022] [Accepted: 01/23/2022] [Indexed: 11/12/2022] Open
Abstract
The anticipation of a future stressor can increase worry and cognitive arousal and has a detrimental effect on sleep. Similarly, experiencing a stressful event directly before sleep increases physiological and cognitive arousal and impairs subsequent sleep. However, the effects of post- vs. pre-sleep stress on sleep and their temporal dynamics have never been directly compared. Here, we examined the effect of an anticipated psychosocial stressor on sleep and arousal in a 90-min daytime nap, in 33 healthy female participants compared to an anticipated within-subject relaxation task. We compared the results to an additional group (n = 34) performing the same tasks directly before sleep. Anticipating stress after sleep reduced slow-wave activity/beta power ratio, slow-wave sleep, sleep spindles, and slow-wave parameters, in particular during late sleep, without a concomitant increase in physiological arousal. In contrast, pre-sleep psychosocial stress deteriorated the same parameters during early sleep with a concomitant increase in physiological arousal. Our results show that presleep cognitions directly affect sleep in temporal proximity to the stressor. While physiological arousal mediates the effects of presleep stress on early sleep, we suggest that effects during late sleep originate from a repeated reactivation of mental concepts associated with the stressful event during sleep.
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Affiliation(s)
- Jonas Beck
- Department of Psychology, University of Fribourg, Rue P.-A-de-Faucigny 2, CH-1700 Fribourg, Switzerland
| | - Erna Loretz
- The Siesta Group Schlafanalyse GmbH, Schlosshofer Strasse 11, 1210 Vienna, Austria
| | - Björn Rasch
- Corresponding author: Department of Psychology, University of Fribourg, Rue P.-A-de-Faucigny 2, CH-1700 Fribourg, Switzerland.
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Arora T, Grey I, Östlundh L, Alamoodi A, Omar OM, Hubert Lam KB, Grandner M. A systematic review and meta-analysis to assess the relationship between sleep duration/quality, mental toughness and resilience amongst healthy individuals. Sleep Med Rev 2022; 62:101593. [DOI: 10.1016/j.smrv.2022.101593] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 01/13/2022] [Accepted: 01/13/2022] [Indexed: 11/28/2022]
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Psychological Wellbeing, Worry, and Resilience-Based Coping during COVID-19 in Relation to Sleep Quality. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:ijerph19010050. [PMID: 35010309 PMCID: PMC8744958 DOI: 10.3390/ijerph19010050] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 12/15/2021] [Accepted: 12/17/2021] [Indexed: 01/15/2023]
Abstract
The current study evaluated the impact of psychological wellbeing on sleep quality during the onset of the COVID-19 pandemic. A novel empirical model tested variables that mediate and moderate this impact. First, a relationship was established between psychological wellbeing during the COVID-19 pandemic and sleep quality. Second, resilience-based coping associated with the COVID-19 pandemic was tested as a mediator of the impact of psychological wellbeing on sleep quality. Third, dispositional rumination, mindfulness, and worry were compared as moderators of the impact of psychological wellbeing on sleep quality. Fourth, a moderated mediated model was tested for each moderator. Online survey data was collected from 153 adults in the United States. Results demonstrated that coping with the COVID-19 pandemic partially mediated the impact of psychological wellbeing on sleep quality. Worry, but not rumination or mindfulness, moderated the impact. A moderated mediation model failed to demonstrate significance, indicating that the data are best represented by distinct mediation and moderation models. Thus, interventions aimed at improving sleep quality should prioritize concurrent reduction in worry and increase in resilience-based coping strategies. This study provides practical and theoretical contribution to the literature by demonstrating relationships between key variables and contextualizing how the model can be used for assessments and interventions during widespread crises.
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Gargiulo AT, Peterson LM, Grafe LA. Stress, coping, resilience, and sleep during the COVID-19 pandemic: A representative survey study of US adults. Brain Behav 2021; 11:e2384. [PMID: 34661981 PMCID: PMC8613418 DOI: 10.1002/brb3.2384] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 09/10/2021] [Accepted: 09/17/2021] [Indexed: 01/10/2023] Open
Abstract
INTRODUCTION The COVID-19 pandemic is a global health emergency resulting in widespread death and substantial disruption to daily life. Previous research has shown that novel disease outbreaks are associated with high stress levels and sleep impairments that lead to neuropsychiatric consequences. Therefore, it is vital to study both stress and protective factors such as coping and resilience that may hinder or help sleep quality during the COVID-19 pandemic. Further, as gender disparities exist in sleep quality, it is important to understand the relationship between pandemic-related stress, coping strategies, resilience, and sleep in bothgenders during the COVID-19 pandemic. METHODS Our study examined how gender, stress, coping, and resilience were associated with sleep cross-sectionally during the COVID-19 pandemic in a representative sample of US adults (N = 393). RESULTS Consistent with many recent studies, we found that worsened sleep quality in women compared to men persisted during the COVID-19 pandemic. Interestingly, pandemic-related stress was not significantly associated with sleep quality, but pandemicrelated coping was associated with sleep independent of robust controls and trait resilience. CONCLUSIONS Greater primary control engagement coping was associated with better sleep quality, while involuntary engagement coping was associated with poor sleep quality. Future research should extend the findings with actigraphy and explore ways to enhance beneficial coping and sleep health during pandemics.
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Affiliation(s)
- Andrew T. Gargiulo
- Department of PsychologyBryn Mawr College Bryn MawrBryn MawrPennsylvaniaUSA
| | - Laurel M. Peterson
- Department of PsychologyBryn Mawr College Bryn MawrBryn MawrPennsylvaniaUSA
| | - Laura A. Grafe
- Department of PsychologyBryn Mawr College Bryn MawrBryn MawrPennsylvaniaUSA
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Investigating racing thoughts in insomnia: A neglected piece of the mood-sleep puzzle? Compr Psychiatry 2021; 111:152271. [PMID: 34555554 DOI: 10.1016/j.comppsych.2021.152271] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 08/12/2021] [Accepted: 09/08/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Cognitive arousal is thought to play a key role in insomnia disorder. However, although patients frequently complain about racing thoughts appearing at bedtime, studies have considered 'cognitive arousal' as a synonym of rumination and worry, but not as racing thoughts per se. The latter have been mainly linked to hypomanic/manic episodes of bipolar disorder (BD). Here we aimed at investigating self-reported racing thoughts in insomnia disorder, and their specific contribution to insomnia severity, as compared to worry and rumination. METHODS 72 adults with insomnia disorder, 49 patients with BD in a hypomanic episode and 99 healthy individuals completed the Racing and Crowded Thoughts Questionnaire (RCTQ). Mood symptoms were assessed in patients with insomnia disorder. RESULTS RCTQ scores were overall higher in insomnia disorder, especially in sleep-onset insomnia, compared to the hypomanic and healthy groups. Moreover, racing thoughts showed an increase in the evening and at bedtime in sleep-onset insomnia. Importantly, racing thoughts at bedtime, but not rumination and worry, were associated with insomnia severity. DISCUSSION Our results are the first to show that racing thoughts is a transdiagnostic symptom in mood and sleep disorders. Racing thoughts, not only rumination and worry, might contribute to the maintenance of sleep difficulties in insomnia. Clinical trials' registration number: NCT04752254.
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Lischetzke T, Schemer L, Glombiewski JA, In-Albon T, Karbach J, Könen T. Negative Emotion Differentiation Attenuates the Within-Person Indirect Effect of Daily Stress on Nightly Sleep Quality Through Calmness. Front Psychol 2021; 12:684117. [PMID: 34456798 PMCID: PMC8385208 DOI: 10.3389/fpsyg.2021.684117] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 07/13/2021] [Indexed: 11/17/2022] Open
Abstract
The ability to differentiate between negative emotional states [negative emotion differentiation (NED)] has been conceptualized as a trait that facilitates effective emotion regulation and buffers stress reactivity. In the present research, we investigated the role of NED in within-person processes of daily affect regulation and coping during times of stress (the first COVID-19-related pandemic lockdown in April 2020). Using intensive longitudinal data, we analyzed whether daily stress had an indirect effect on sleep quality through calmness in the evening, and we tested whether NED moderated this within-person indirect effect by buffering the link between daily stress and calmness in the evening. A non-representative community sample (n = 313, 15–82 years old) participated in a 21-day ambulatory assessment with twice-daily surveys. The results of multilevel mediation models showed that higher daily stress was related to within-day change in calmness from morning to evening, resulting in less calmness in the evening within persons. Less calmness in the evening, in turn, was related to poorer nightly sleep quality within persons. As expected, higher NED predicted a less negative within-person link between daily stress and calmness in the evening, thereby attenuating the indirect effect of daily stress on nightly sleep quality through calmness. This effect held when we controlled for mean negative emotions and depression. The results provide support for a diathesis-stress model of NED, and hence, for NED as a protective factor that helps to explain why some individuals remain more resilient during times of stress than others.
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Affiliation(s)
- Tanja Lischetzke
- Department of Psychology, University of Koblenz-Landau, Landau, Germany
| | - Lea Schemer
- Department of Psychology, University of Koblenz-Landau, Landau, Germany
| | | | - Tina In-Albon
- Department of Psychology, University of Koblenz-Landau, Landau, Germany
| | - Julia Karbach
- Department of Psychology, University of Koblenz-Landau, Landau, Germany
| | - Tanja Könen
- Department of Psychology, University of Koblenz-Landau, Landau, Germany
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Effects of biopsychosocial factors on the association between loneliness and mental health risks during the COVID-19 lockdown. CURRENT PSYCHOLOGY 2021; 41:8224-8235. [PMID: 34456535 PMCID: PMC8380098 DOI: 10.1007/s12144-021-02246-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2021] [Indexed: 12/12/2022]
Abstract
Previous data suggest that loneliness is a hallmark of the mental health issues triggered by the SARS-CoV-2 pandemic. The purpose of the present study was to examine the impact of loneliness on mental health and behavioural outcomes, as well as the moderating and mediating effects of biopsychosocial variables on these relationships. The data were collected during France’s first national COVID-19 lockdown and included 556 participants (Mage = 30.06 years, range = 18–87) who completed well-known validated measures assessing symptom-levels of anxiety, depression, and insomnia. They also indicated their level of worry about the COVID-19 crisis, and provided sociodemographic and health status data. Responses were submitted to hierarchical linear regression and mediation analyses. In terms of prevalence of loneliness, 18.9% of participants reported severe loneliness. High levels of loneliness were significantly associated with the three mental health and behavioural outcomes. The loneliness – anxiety relationship was moderated by employment and working arrangements. The loneliness – insomnia relationship was moderated by living conditions, history of medical or psychological problems, and COVID-19-related worry. Further findings supported the indirect effects of COVID-related worry on pathways from loneliness to the three mental health and behavioural health outcomes. The mediation models accounted for 28.9%, 33.7%, and 15.0% of the variance in anxiety, depression, and insomnia. The present evidence-based findings revealed that loneliness and worry were major contributing factors of mental health and behavioural concerns during the COVID-19 lockdown. They could inform treatment recommendations for tackling prolonged-self isolation and loneliness in specific vulnerable groups.
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Kahn M, Barnett N, Glazer A, Gradisar M. COVID-19 babies: auto-videosomnography and parent reports of infant sleep, screen time, and parent well-being in 2019 vs 2020. Sleep Med 2021; 85:259-267. [PMID: 34388504 PMCID: PMC8418313 DOI: 10.1016/j.sleep.2021.07.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 06/29/2021] [Accepted: 07/20/2021] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The COVID-19 pandemic has profoundly impacted families, yet studies on its effects on infants and their parents have thus far been sparse and based mostly on retrospective parent reporting. This study aimed to prospectively evaluate the impact of COVID-19 living conditions on infant and parent sleep, as well as infant screen exposure, parent daytime sleepiness, and parent depression levels, using multi-method assessment. METHODS Infant and parent data collected in 2020 were compared with a matched cohort collected in 2019. The total sample included 1518 US infants aged 1-18 months (M = 8.5, SD = 4.6; 54% boys). Auto-videosomnography metrics were obtained from the 14-day period prior to survey completion (number of analyzed nights: M = 12.11 SD = 2.66 in the 2019 cohort; and M = 11.91 SD = 2.41 in the 2020 cohort). Parents completed online questionnaires regarding their infant's sleep and screen exposure, as well as their own sleep quality, daytime sleepiness, and depression levels. RESULTS Compared to 2019, infants in 2020 slept ∼40 min more per night on average, as indicated by auto-videosomnography. Infants additionally had earlier sleep timing, and increased parent-reported sleep-onset latency and nocturnal wakefulness. Infant screen time rose by 18.3 min per day for older infants, but remained stable for younger infants. Parents reported lower daytime sleepiness and higher depression symptomology during 2020, whereas no change was apparent in their sleep quality ratings. CONCLUSIONS Restricted living conditions during COVID-19 in the USA led to increased infant screen exposure and parental depression, but also to increased infant sleep duration and reduced parent sleepiness. Future research is needed to examine the mechanistic pathways through which COVID-19 impacted on infant and parent well-being.
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Affiliation(s)
- Michal Kahn
- Flinders University, College of Education, Psychology and Social Work, SA, Australia.
| | | | | | - Michael Gradisar
- Flinders University, College of Education, Psychology and Social Work, SA, Australia
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Adams SK, Mushkat Z, Minkel J. Examining the Moderator Role of Sleep Quality in the Relationship Among Test Anxiety, Academic Success and Mood. Psychol Rep 2021; 125:2400-2415. [PMID: 34134557 DOI: 10.1177/00332941211025268] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study explored associations among test anxiety, GPA, sleep quality, and mood in college students. Data were collected from undergraduate students (N = 316). Results revealed that higher levels of test anxiety and sleep impairment predicted negative mood in undergraduates. Findings suggest that prioritizing sleep could help improve overall mood among students with test anxiety. Future studies should work toward clarifying the complex and reciprocal relationship between sleep and test anxiety.
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Affiliation(s)
- Sue K Adams
- Department of Human Development and Family Science, The 4260University of Rhode Island, Kingston, RI, USA
| | - Zoe Mushkat
- Department of Psychology, The 4260University of Rhode Island, Kingston, RI, USA
| | - Jared Minkel
- Department of Psychology, The 4260University of Rhode Island, Kingston, RI, USA
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Bai S, Chang Q, Yao D, Zhang Y, Wu B, Zhao Y. Anxiety in Residents in China: Prevalence and Risk Factors in a Multicenter Study. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2021; 96:718-727. [PMID: 33464742 DOI: 10.1097/acm.0000000000003913] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
PURPOSE To explore the prevalence of major anxiety and its associated risk factors in residents in China. METHOD This multicenter, cross-sectional study was conducted from December 2019 to February 2020; 1,343 residents from 8 hospitals in Northeast China were included in the final analysis (effective response rate of 86.48%). Demographic characteristics, dietary habits, life-related factors, work-related factors, and psychological characteristics were collected from participants via a self-reported questionnaire. This questionnaire measured sleep quality, physical activity, anxiety, perceived organizational support, psychological capital, and burnout. Adjusted odds ratios (ORs) and 95% confidence intervals were determined using binary logistic regression. Cutoff values and the area under the curve were calculated for risk factors using receiver operating characteristic curve analysis. RESULTS Of participants, 441 (32.80%) reported anxiety symptoms and 133 (9.90%) reported major anxiety symptoms. Four independent risk factors for major anxiety were identified: poor sleep quality (OR = 1.282, P < .001) and 3 dimensions of burnout: higher emotional exhaustion (OR = 1.085, P < .001), higher depersonalization (OR = 1.064, P = .002), and reduced personal accomplishment (OR = 0.951, P < .001). The optimal cutoff values for these risk factors were 7, 10, 9, and 22 scores, respectively. CONCLUSIONS This study found a considerable prevalence of major anxiety symptoms in residents in China and identified poor sleep quality and higher levels of burnout as having a close association with major anxiety. These findings enrich the existing literature on anxiety and demonstrate a critical need for additional studies that investigate intervention strategies to improve sleep quality and combat burnout, which could improve the mental health of residents.
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Affiliation(s)
- Song Bai
- S. Bai is associate professor, Department of Urology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qing Chang
- Q. Chang is associate director, Department of Graduate Medical Education, Health Service Center of Liaoning Province, Shenyang, China
| | - Da Yao
- D. Yao is a student, Department of Graduate Medical Education, Health Service Center of Liaoning Province, Shenyang, China
| | - Yixiao Zhang
- Y. Zhang is a resident, Department of Urology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Bin Wu
- B. Wu is director, Department of Urology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yuhong Zhao
- Y. Zhao is director, Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
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Psychosocial stress, sleep quality and interest in mind-body integrative health sleep intervention among urban adolescents in the school-based health setting. Complement Ther Med 2021; 58:102714. [PMID: 33766621 PMCID: PMC10119780 DOI: 10.1016/j.ctim.2021.102714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 03/15/2021] [Accepted: 03/19/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Mind-body integrative health (MBIH) interventions to improve adolescent sleep are lacking. The study characterized sleep quality and bedtime-related psychosocial stressors among urban minority adolescents, explored associations between demographics factors, stressors and sleep quality, and gauged interest in a MBIH sleep intervention. MATERIALS AND METHODS 167 school-based health center (SBHC) patients (mean age = 16.3; 64 % female; 68 % Latino) participated in a needs assessment as part of a quality improvement project. They reported bedtime-related psychosocial stressors using items from the Adolescent Sleep Hygiene Scale (ASHS), sleep quality using the Pittsburgh Sleep Quality Index (PSQI), and interest in a MBIH-based sleep intervention. Chi-square and logistic regression examined associations between demographics, stressors, sleep quality, and interest in the intervention. RESULTS 67 % had poor sleep quality. Females, compared to males, had 2.23 higher odds (95 % Confidence Interval [CI]: 1.12, 4.42) of having poor sleep quality. Nearly 80 % experienced bedtime-related stressors (25 % experienced one stressor, 17 % two stressors and 37 % three or more stressors); relative to those reporting no stressors, those reporting 3+ stressors had 3.15 higher odds (95 % CI: 1.27, 7.84) of having poor sleep quality. Most (77 %) reported they would participate in an SBHC-based intervention that utilized MBIH modalities preferring both one-on-one and group sessions. CONCLUSIONS Urban, predominantly Hispanic and Black, SBHC adolescent patients have poor sleep quality and report bedtime-related psychosocial stressors. Their interest in MBIH interventions to address sleep problems represents a unique opportunity for practitioners and complementary therapists to offer MBIH interventions to a population at high-risk for poor sleep quality.
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Tutek J, Gunn HE, Lichstein KL. Worry and Rumination Have Distinct Associations with Nighttime versus Daytime Sleep Symptomology. Behav Sleep Med 2021; 19:192-207. [PMID: 32036690 DOI: 10.1080/15402002.2020.1725012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Objective: To assess whether worry and rumination differ in predicting nighttime sleep disturbance versus daytime sleep-related impairment, as assessed using short forms from the Patient Reported Outcomes Measurement Information System (PROMIS). Participants: Adults recruited from the United States population (N = 459) via an online crowdsourcing service. Methods: Factor analysis explored whether items comprising validated measures of worry and rumination loaded onto separate factors. Hierarchical multiple regression models entered worry and rumination in a stepwise fashion to assess their relative strength in predicting PROMIS sleep disturbance and sleep-related impairment, after controlling for 17 covariates. All analyses were run twice using sleep-specific and general measures of worry and rumination. Results: Worry and rumination items loaded onto separate factors. In the regression analysis of sleep-specific cognition, only worry entered the model predicting sleep disturbance, whereas rumination entered after worry in the model predicting sleep-related impairment. In the analysis of general cognition, both cognitive process variables significantly predicted the PROMIS outcomes. Worry was the stronger predictor of sleep disturbance, whereas rumination was the stronger predictor of sleep-related impairment. Conclusions: Worry and rumination were observed to be distinct constructs that separately contributed to predicting daytime sleep-related impairment. Future studies should more closely examine how cognitive processes relate to insomnia symptomology during the day.
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Affiliation(s)
- Joshua Tutek
- Department of Psychology, The University of Alabama , Tuscaloosa, Alabama
| | - Heather E Gunn
- Department of Psychology, The University of Alabama , Tuscaloosa, Alabama
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You Z, Li X, Ye N, Zhang L. Understanding the effect of rumination on sleep quality: a mediation model of negative affect and bedtime procrastination. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-020-01337-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Rosano J, Howell T, Conduit R, Bennett P. Co-Sleeping between Adolescents and Their Pets May Not Impact Sleep Quality. Clocks Sleep 2021; 3:1-11. [PMID: 33406702 PMCID: PMC7838871 DOI: 10.3390/clockssleep3010001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 12/01/2020] [Accepted: 12/16/2020] [Indexed: 11/25/2022] Open
Abstract
Pet–owner co-sleeping is increasingly common in some parts of the world. Adult owners often subjectively report benefits of co-sleeping with pets, although objective actigraphy reports conversely indicate sleep disruptions due to the pet. Because limited research is available regarding pet–owner co-sleeping in non-adult samples, the aim of this two-part study was to explore whether co-sleeping improves sleep quality in adolescents, an age group in which poor sleep patterns are well documented. In Study One, an online survey with 265 pet-owning 13-to-17-year-old participants found that over 78% co-slept with their pet. Average sleep quality scores for co-sleepers and non-co-sleepers indicated generally poor sleep, with no differences in sleep quality depending on age, gender, or co-sleeping status. Study Two consisted of two preliminary case studies, using actigraphy on dog–adolescent co-sleepers. In both cases, high sleep concordance was observed, but owners again experienced generally poor sleep quality. Future actigraphy research is needed, including larger sample sizes and a control group of non-co-sleepers, to validate the preliminary findings from this study, but our limited evidence suggests that co-sleeping with a pet may not impact sleep quality in adolescents.
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Affiliation(s)
- Jessica Rosano
- Anthrozoology Research Group, School of Psychology and Public Health, La Trobe University, Bendigo, VIC 3552, Australia; (J.R.); (P.B.)
| | - Tiffani Howell
- Anthrozoology Research Group, School of Psychology and Public Health, La Trobe University, Bendigo, VIC 3552, Australia; (J.R.); (P.B.)
- Correspondence:
| | - Russell Conduit
- School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC 3083, Australia;
| | - Pauleen Bennett
- Anthrozoology Research Group, School of Psychology and Public Health, La Trobe University, Bendigo, VIC 3552, Australia; (J.R.); (P.B.)
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Huang Y, Zhou Y, Wei Y, Zeng L, Yang J, Li Y, Song X, Li H, He H, Li T, Wu K, Yang M, Wu F, Ning Y, Zhang X. Differences in the Association of Anxiety, Insomnia and Somatic Symptoms between Medical Staff and the General Population During the Outbreak of COVID-19. Neuropsychiatr Dis Treat 2021; 17:1907-1915. [PMID: 34163164 PMCID: PMC8214107 DOI: 10.2147/ndt.s300719] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 04/27/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND During the outbreak of coronavirus disease 2019 (COVID-19), occupational differences were recognized with respect to psychological issues, but there are no reports regarding the insomnia and anxiety comorbidities and their related factors among the general public and medical staff. Our study aimed to compare the prevalence of anxiety and anxiety with insomnia, as well as the relationship between different psychological symptoms between the two groups. METHODS A total of 605 medical staff and 1091 public respondents were assessed through an online questionnaire survey, including the 7-item Insomnia Severity Index (ISI), the somatization subscale of Symptom Checklist 90-Revised (SCL-90-R), and the 7-item Generalized Anxiety Disorder scale (GAD-7). RESULTS Compared with the general public, medical staff had a higher incidence of anxiety (45.5% vs 32.4%). The incidence of insomnia in anxious participants was 52.7% in medical staff and 44.6% in the general public, and the difference was significant (p < 0.05). The GAD-7 score and somatization subscore of the SCI-90 were independently associated with insomnia among anxiety participants in both groups (all p < 0.001). CONCLUSION Our findings suggest that during the epidemic period of COVID-19, medical staff experienced more anxiety and anxiety with insomnia. Somatization, anxiety and insomnia are highly correlated among medical staff and the general public.
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Affiliation(s)
- Yuanyuan Huang
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, People's Republic of China
| | - Yongjie Zhou
- Department of Psychiatry, Shenzhen Kangning Hospital, Shenzhen, People's Republic of China
| | - Yi Wei
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, People's Republic of China
| | - Lingyun Zeng
- Department of Psychiatry, Shenzhen Kangning Hospital, Shenzhen, People's Republic of China
| | - Jiezhi Yang
- Department of Psychiatry, Shenzhen Health Development Research Center, Shenzhen, People's Republic of China
| | - Yi Li
- Department of Psychiatry, Shenzhen Kangning Hospital, Shenzhen, People's Republic of China
| | - Xiuli Song
- Clinical Psychology, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, People's Republic of China
| | - Hehua Li
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, People's Republic of China
| | - Hongbo He
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, People's Republic of China
| | - Ting Li
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, People's Republic of China
| | - Kai Wu
- Department of Biomedical Engineering, School of Materials Science and Engineering, South China University of Technology (scUT), Guangzhou, People's Republic of China
| | - Mingzhe Yang
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, People's Republic of China
| | - Fengchun Wu
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, People's Republic of China.,Department of Psychiatry, Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, People's Republic of China.,The First School of Clinical Medicine, Southern Medical University, Guangzhou, People's Republic of China
| | - Yuping Ning
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, People's Republic of China.,The First School of Clinical Medicine, Southern Medical University, Guangzhou, People's Republic of China
| | - Xiangyang Zhang
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, People's Republic of China.,CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, People's Republic of China
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40
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Cordi MJ. Updated Review of the Acoustic Modulation of Sleep: Current Perspectives and Emerging Concepts. Nat Sci Sleep 2021; 13:1319-1330. [PMID: 34335067 PMCID: PMC8318210 DOI: 10.2147/nss.s284805] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 07/12/2021] [Indexed: 11/23/2022] Open
Abstract
With growing interest in the use of acoustic stimuli in sleep research and acoustic interventions used therapeutically for sleep enhancement, there is a need for an overview of the current lines of research. This paper summarizes the various ways to use acoustic input before sleep or stimulation during sleep. It thereby focuses on the respective methodological requirements, advantages, disadvantages, potentials and difficulties of acoustic sleep modulation. It highlights differences in subjective and objective outcome measures, immediate and whole night effects and short versus long term effects. This recognizes the fact that not all outcome parameters are relevant in every research field. The same applies to conclusions drawn from other outcome dimensions, consideration of mediating factors, levels of stimulation processing and the impact of inter-individual differences. In addition to the deliberate influences of acoustic input on sleep, one paragraph describes adverse environmental acoustic influences. Finally, the possibilities for clinical and basic research-related applications are discussed, and emerging opportunities are presented. This overview is not a systematic review but aims to present the current perspective and hence summarizes the most up-to-date research results and reviews. This is the first review providing a summary of the broad spectrum of possibilities to acoustically influence sleep.
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Affiliation(s)
- Maren Jasmin Cordi
- Department of Psychology, Division of Cognitive Biopsychology and Methods, University of Fribourg, Fribourg, Switzerland.,Centre of Competence Sleep & Health Zurich, University of Zurich, Zurich, Switzerland
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41
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Mindfulness and Behaviour Therapy for Insomnia: An Assessment of Treatment Effect in a Sleep Disorders Clinic Population with Insomnia. BEHAVIOUR CHANGE 2020. [DOI: 10.1017/bec.2020.18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractInsomnia is a common major health concern, which causes significant distress and disruption in a person's life. The objective of this paper was to evaluate a 6-week version of Mindfulness-Based Therapy for Insomnia (MBTI) in a sample of people attending a sleep disorders clinic with insomnia, including those with comorbidities. Thirty participants who met the DSM-IV-TR diagnosis of insomnia participated in a 6-week group intervention. Outcome measures were a daily sleep diary and actigraphy during pre-treatment and follow-up, along with subjective sleep outcomes collected at baseline, end-of-treatment, and 3-month follow-up. Trend analyses showed that MBTI was associated with a large decrease in insomnia severity (p < .001), with indications of maintenance of treatment effect. There were significant improvements in objective sleep parameters, including sleep onset latency (p = .005), sleep efficiency (p = .033), and wake after sleep onset (p = .018). Significant improvements in subjective sleep parameters were also observed for sleep efficiency (p = .005) and wake after sleep onset (p < .001). Overall, this study indicated that MBTI can be successfully delivered in a sleep disorders clinic environment, with evidence of treatment effect for both objective and subjective measures of sleep.
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Waldeck D, Banerjee M, Jenks R, Tyndall I. Cognitive arousal mediates the relationship between perceived ostracism and sleep quality but it is not moderated by experiential avoidance. Stress Health 2020; 36:487-495. [PMID: 32314874 DOI: 10.1002/smi.2946] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 03/18/2020] [Accepted: 03/25/2020] [Indexed: 11/10/2022]
Abstract
Previous research suggests that longer-term perceived ostracism is related to poor sleep quality. In this study, we investigated the mediating effect of cognitive arousal on the perceived ostracism-sleep quality relationship. We also investigated whether experiential avoidance was a moderator of the cognitive arousal-sleep quality relationship. Participants (N = 251) were recruited through online research portals to take part in an online survey. A path analysis was used to test a moderated mediation effect between variables. It was found that cognitive arousal mediated the perceived ostracism-sleep quality relationship; however, experiential avoidance was not a significant moderator. These findings suggest that further research needs to be conducted to elucidate the mechanism of experiential avoidance to account for when it may impact sleep quality. Moreover, treatment interventions targeted at reducing cognitive arousal (e.g., cognitive behavioural therapy) prior to sleep are likely to bear some fruit.
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Affiliation(s)
- Daniel Waldeck
- Department of Psychology, Coventry University, Coventry, UK
| | - Moitree Banerjee
- Department of Psychology, University of Chichester, Chichester, UK
| | - Rebecca Jenks
- Department of Psychology, Coventry University, Coventry, UK
| | - Ian Tyndall
- Department of Psychology, University of Chichester, Chichester, UK
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43
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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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44
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Kalmbach DA, Buysse DJ, Cheng P, Roth T, Yang A, Drake CL. Nocturnal cognitive arousal is associated with objective sleep disturbance and indicators of physiologic hyperarousal in good sleepers and individuals with insomnia disorder. Sleep Med 2020; 71:151-160. [PMID: 32247571 PMCID: PMC8212183 DOI: 10.1016/j.sleep.2019.11.1184] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 11/01/2019] [Accepted: 11/02/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND Cognitive arousal is central to models of sleep disturbance and insomnia, but findings remain mixed regarding whether cognitive arousal is associated with objective sleep disturbance and physiologic hyperarousal. This study explored associations of objective nocturnal wakefulness and indicators of physiologic hyperarousal with cognitive arousal in healthy sleepers and individuals with insomnia. METHODS In sum, 52 adults (51.9% women; 18 with insomnia disorder, 34 healthy sleepers) underwent two overnight polysomnography (PSG) studies (adaptation + baseline nights) and a multiple sleep latency test (MSLT). Baseline depression was assessed and presleep cognitive arousal and somatic arousal were recorded for each night. Multivariate regression was used to evaluate associations of PSG sleep parameters with insomnia, cognitive arousal, and somatic arousal. RESULTS Analyses showed that high levels of nocturnal cognitive arousal were associated with prolonged sleep latency, lower sleep efficiency, and shorter total sleep time by PSG on both nights. An association between nocturnal cognitive arousal and wake after sleep onset was observed on night one only. Moreover, greater nocturnal cognitive arousal was associated with greater likelihood of obtaining short sleep and with longer MSLT sleep latencies. Insomnia diagnosis, depression, and somatic arousal were not associated with PSG sleep parameters or MSLT latency. CONCLUSIONS Heightened cognitive arousal at night is linked to objective sleep disturbances and indicators of physiologic hyperarousal at night and during the day. For patients with insomnia, cognitive arousal may contribute to the 24-hr physiologic hyperarousal. Cognitive arousal may be a critical therapeutic target for severe or treatment-resistant sleep disturbance.
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Affiliation(s)
- David A Kalmbach
- Thomas Roth Sleep Disorders & Research Center, Division of Sleep Medicine, Henry Ford Health System, Detroit, MI 48202 USA
| | - Daniel J Buysse
- Center for Sleep and Circadian Science, Departments of Psychiatry and Clinical and Translational Science, University of Pittsburgh Medical Center, Pittsburgh, PA 15213 USA
| | - Philip Cheng
- Thomas Roth Sleep Disorders & Research Center, Division of Sleep Medicine, Henry Ford Health System, Detroit, MI 48202 USA
| | - Thomas Roth
- Thomas Roth Sleep Disorders & Research Center, Division of Sleep Medicine, Henry Ford Health System, Detroit, MI 48202 USA
| | - Alexander Yang
- Thomas Roth Sleep Disorders & Research Center, Division of Sleep Medicine, Henry Ford Health System, Detroit, MI 48202 USA
| | - Christopher L Drake
- Thomas Roth Sleep Disorders & Research Center, Division of Sleep Medicine, Henry Ford Health System, Detroit, MI 48202 USA
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Kuula L, Halonen R, Kajanto K, Lipsanen J, Makkonen T, Peltonen M, Pesonen AK. The Effects of Presleep Slow Breathing and Music Listening on Polysomnographic Sleep Measures - a pilot trial. Sci Rep 2020; 10:7427. [PMID: 32366866 PMCID: PMC7198497 DOI: 10.1038/s41598-020-64218-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 04/08/2020] [Indexed: 02/04/2023] Open
Abstract
Knowledge on efficient ways to reduce presleep arousal and, therefore, improve sleep, is scanty. We explored the effects of presleep slow breathing and music listening conditions on sleep quality and EEG power spectral density in young adults in a randomized, controlled trial with a crossover design. Participants’ (N = 20, 50% females) sleep was measured on two consecutive nights with polysomnography (40 nights), the other night serving as the control condition. The intervention condition was either a 30-minute slow breathing exercise or music listening (music by Max Richter: Sleep). The intervention and control conditions were placed in a random order. We measured heart rate variability prior to, during and after the intervention condition, and found that both interventions increased immediate heart rate variability. Music listening resulted in decreased N2 sleep, increased frontal beta1 power spectral density, and a trend towards increased N3 sleep was detected. In the slow breathing condition higher central delta power during N3 was observed. While some indices pointed to improved sleep quality in both intervention groups, neither condition had robust effects on sleep quality. These explorative findings warrant further replication in different populations.
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Affiliation(s)
- Liisa Kuula
- SleepWell Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
| | - Risto Halonen
- SleepWell Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Kristiina Kajanto
- SleepWell Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Jari Lipsanen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Tommi Makkonen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Miina Peltonen
- Department of oral and maxillofacial diseases, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Anu-Katriina Pesonen
- SleepWell Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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Cox RC, Olatunji BO. Sleep in the anxiety-related disorders: A meta-analysis of subjective and objective research. Sleep Med Rev 2020; 51:101282. [PMID: 32109832 DOI: 10.1016/j.smrv.2020.101282] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 01/07/2020] [Accepted: 01/09/2020] [Indexed: 02/04/2023]
Abstract
Although sleep disturbance is implicated in psychopathology, its role in anxiety-related disorders remains unclear. The present meta-analysis characterizes sleep disturbance in anxiety-related disorders collectively and individually. Subjective measures of total sleep time and sleep continuity were included with objective measures. Results indicate a large effect for increased subjective sleep disturbance (g = 2.16), medium effects for decreased total sleep time (g = -.40) and sleep continuity (g = -.49), and a small effect for decreased sleep depth (g = -.20) in anxiety-related disorders compared to healthy controls. Each anxiety-related disorder exhibited a distinct sleep disturbance pattern, suggesting that sleep may facilitate identification of unique biopsychological underpinnings. Effects were not moderated by comorbid depression and were similar in magnitude to those found for depression. Sleep disturbances, particularly decreased sleep continuity, may be a key pathology in the anxiety-related disorders that could highlight novel etiological mechanisms and intervention targets.
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Affiliation(s)
- Rebecca C Cox
- Department of Psychology, Vanderbilt University, 301 Wilson Hall, 111 21st Avenue South, Nashville, TN 37240, USA.
| | - Bunmi O Olatunji
- Department of Psychology, Vanderbilt University, 301 Wilson Hall, 111 21st Avenue South, Nashville, TN 37240, USA
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余 佳, 刘 可, 刘 帅. [Relationship between coping style and insomnia in college students: the mediating effect of rumination]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2020; 40:137-141. [PMID: 32376569 PMCID: PMC7040762 DOI: 10.12122/j.issn.1673-4254.2020.01.22] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Indexed: 11/24/2022]
Abstract
ObjectiveTo explore the mediating effect of rumination on coping style and insomnia in college students.MethodWe surveyed 767 college students from a university in Sichuan Province using Insomnia Severity Index (ISI), Ruminative Responses Scale (RRS), and Trait Coping Style Questionnaire (TCSQ).ResultsThe prevalence of insomnia was 36.6% in the surveyed college students. Positive coping style was negatively correlated with the total score and scores in each dimension of RRS (r=-0.127~-0.116, P < 0.001), and was negatively correlated with the total score of ISI (r=-0.159, P < 0.001). Negative coping style was positively correlated with the total score and the scores in each dimension of RRS (r=0.298-0.334, P < 0.001), and was positively correlated with the total score of ISI (r=0.264, P < 0.001). The total score and the scores in each dimension of RRS were positively correlated with the total score of ISI (r=0.251-0.281, P < 0.001). Rumination had a partial mediating effect on both positive and negative coping style and insomnia.ConclusionCoping style affects insomnia in college students not only directly but also indirectly through the mediating effect of rumination.
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Affiliation(s)
- 佳 余
- 西南医科大学附属医院精神科,四川 泸州 646000Department of Psychiatry, Affiliated Hospital of Southwest Medical University, Luzhou 646000, China
- 攀枝花市第三人民医院,四川 攀枝花 617061Third People's Hospital of Panzhihua, Panzhihua 617061, China
| | - 可智 刘
- 西南医科大学附属医院精神科,四川 泸州 646000Department of Psychiatry, Affiliated Hospital of Southwest Medical University, Luzhou 646000, China
| | - 帅 刘
- 南方医科 大学南方医院精神心理科,广东 广州 510515Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
- 青海省第三人民医院,青海 西宁 810007Third People's Hospital of Qinghai Province, Xining 810007, China
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