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Mukty SA, Hasan R, Bhuia MS, Saha AK, Rahman US, Khatun MM, Bithi SA, Ansari SA, Ansari IA, Islam MT. Assessment of sedative activity of fraxin: In vivo approach along with receptor binding affinity and molecular interaction with GABAergic system. Drug Dev Res 2024; 85:e22250. [PMID: 39154218 DOI: 10.1002/ddr.22250] [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: 06/30/2024] [Revised: 07/17/2024] [Accepted: 08/04/2024] [Indexed: 08/19/2024]
Abstract
Insomnia is a sleep disorder in which you have trouble falling and/or staying asleep. This research aims to evaluate the sedative effects of fraxin (FX) on sleeping mice induced by thiopental sodium (TS). In addition, a molecular docking study was conducted to investigate the molecular processes underlying these effects. The study used adult male Swiss albino mice and administered FX (10 and 20 mg/kg, i.p.) and diazepam (DZP) (2 mg/kg) either separately or in combination within the different groups to examine their modulatory effects. After a period of 30 min, the mice that had been treated were administered (TS: 20 mg/kg, i.p.) to induce sleep. The onset of sleep for the mice and the length of their sleep were manually recorded. Additionally, a computational analysis was conducted to predict the role of gamma-aminobutyric acid (GABA) receptors in the sleep process and evaluate their pharmacokinetics and toxicity. The outcomes indicated that FX extended the length of sleep and reduced the time it took to fall asleep. When the combined treatment of FX and DZP showed synergistic sedative action. Also, FX had a binding affinity of -7.2 kcal/mol, while DZP showed -8.4 kcal/mol. The pharmacokinetic investigation of FX demonstrated favorable drug-likeness and strong pharmacokinetic characteristics. Ultimately, FX demonstrated a strong sedative impact in the mouse model, likely via interacting with the GABAA receptor pathways.
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Affiliation(s)
- Sonaly Akter Mukty
- Department of Pharmacy, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj, Bangladesh
- Bioinformatics and Drug Innovation Laboratory, BioLuster Research Center Ltd., Gopalganj, Dhaka, Bangladesh
| | - Rubel Hasan
- Department of Pharmacy, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj, Bangladesh
- Bioinformatics and Drug Innovation Laboratory, BioLuster Research Center Ltd., Gopalganj, Dhaka, Bangladesh
| | - Md Shimul Bhuia
- Department of Pharmacy, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj, Bangladesh
- Bioinformatics and Drug Innovation Laboratory, BioLuster Research Center Ltd., Gopalganj, Dhaka, Bangladesh
| | - Anik Kumar Saha
- Department of Pharmacy, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj, Bangladesh
| | - Umme Sadea Rahman
- Bioinformatics and Drug Innovation Laboratory, BioLuster Research Center Ltd., Gopalganj, Dhaka, Bangladesh
| | - Mst Muslima Khatun
- Department of Pharmacy, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj, Bangladesh
| | - Sumaya Akter Bithi
- Department of Pharmacy, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj, Bangladesh
| | - Siddique Akber Ansari
- Department of Pharmaceutical Chemistry, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Irfan Aamer Ansari
- Department of Drug Science and Technology, University of Turin, Turin, Italy
| | - Muhammad Torequl Islam
- Department of Pharmacy, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj, Bangladesh
- Bioinformatics and Drug Innovation Laboratory, BioLuster Research Center Ltd., Gopalganj, Dhaka, Bangladesh
- Pharmacy Discipline, Khulna University, Khulna, Bangladesh
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Yao L, Liang K, Huang L, Chi X. Relationship between fruit and vegetable consumption and internet addiction with insomnia and depression as multiple mediators during the COVID-19 pandemic: a three-wave longitudinal study in Chinese college students. BMC Psychiatry 2023; 23:939. [PMID: 38093234 PMCID: PMC10720225 DOI: 10.1186/s12888-023-05415-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 11/28/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND The relationships between fruit and vegetable consumption (FV) and Internet addiction (IA) in college students still remained unknown together with the internal mechanisms. Given the limitations of previous cross-sectional design, longitudinal research was necessary to be conducted to explore more precise correlations. Using the three-wave data in a longitudinal design, this study aimed to explore the association between FV and IA among Chinese college students and potential multiple mediators of insomnia and depression during the COVID-19 pandemic. METHODS A total of 579 college students were recruited during three waves (T1: August 2020; T2: November 2020; T3: February 2021). FV (T1), insomnia (T2), depression (T2) and IA (T3) symptoms were reported. The descriptive statistics of the sociodemographic characteristics and correlation analyses of the study variables were calculated. The significance of the mediation effects was measured conducting a bootstrap method with SPSS PROCESS macro. RESULTS FV was negatively correlated with IA, and lower FV predicted higher risk of IA. Depression mediated the association between FV and subsequent IA. Insomnia and depression were multiple mediators, which in turn mediated the links between FV and subsequent IA. CONCLUSIONS The three-wave longitudinal study has revealed that FV had indirect effects on IA through individual mediating factor of depression and multiple mediating roles of insomnia and depression sequentially. The policy makers, educators and researchers should pay attention to the impact of the interventions from healthy diet, in order to optimize the coping strategies for preventing college students from IA.
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Affiliation(s)
- Liqing Yao
- School of Pharmacy, Guangdong Pharmaceutical University, Guangzhou, China
- Faculty of Medicine, Medical Sciences Division, Macau University of Science and Technology, Macau, China
| | - Kaixin Liang
- School of Psychology, Shenzhen University, Shenzhen, China
- The Shenzhen Humanities & Social Sciences Key Research Bases of the Center for Mental Health, Shenzhen University, Shenzhen, China
- Department of Psychology, Faculty of Social Sciences, University of Macau, Macau, China
| | - Liuyue Huang
- Department of Psychology, Faculty of Social Sciences, University of Macau, Macau, China
| | - Xinli Chi
- School of Psychology, Shenzhen University, Shenzhen, China.
- The Shenzhen Humanities & Social Sciences Key Research Bases of the Center for Mental Health, Shenzhen University, Shenzhen, China.
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Michaud AL, Bice B, Miklos E, McCormick K, Medeiros-Nancarrow C, Zhou ES, Recklitis CJ. Sleep Treatment Education Program for Young Adult Cancer Survivors (STEP-YA): Protocol for an Efficacy Trial. JMIR Res Protoc 2023; 12:e52315. [PMID: 38019571 PMCID: PMC10719817 DOI: 10.2196/52315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 10/10/2023] [Accepted: 10/13/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Young adult cancer survivors (YACS) are at elevated risk for chronic insomnia, even years after completing treatment. In addition to potential health consequences, insomnia can interrupt social, educational, and vocational development just as they are trying to "make up" for time lost to cancer. Cognitive behavioral therapy for insomnia (CBTI) is recommended as first-line treatment for insomnia but remains largely unavailable to YACS due to several barriers (ie, shortage of trained providers, geographic limitations, financial limitations). Traditional CBTI has not been adapted to meet YACS' unique developmental and circadian challenges. To improve availability of effective behavioral insomnia treatment for this population, we developed the Sleep Treatment Education Program for Young Adult Cancer Survivors (STEP-YA), a low-intensity educational intervention delivered virtually online. OBJECTIVE In this phase 2 "proof of concept" trial, primary aims are to test the efficacy of STEP-YA to improve insomnia symptoms and mood in YACS and assess the utility of individualized coaching to improve treatment effects. A secondary aim will explore participant variables associated with clinically significant response to STEP-YA. METHODS This 2-arm randomized prospective trial will enroll 74 off-treatment YACS aged 20 years to 39 years with clinically significant insomnia. Each participant completes the STEP-YA intervention in a 1-on-1 synchronous online session led by a trained interventionist following a structured outline. The 90-minute intervention presents educational information on the development of insomnia after cancer and offers specific suggestions for improving insomnia symptoms. During the session, participants review the suggestions and develop a personalized sleep action plan for implementing them. After the session, participants are randomized to either the coaching condition, in which they receive 2 telephone coaching sessions, or the no-coaching condition, which offers no subsequent coaching. The Insomnia Severity Index (ISI) and the Profile of Mood States: Short Form (POMS-SF) are assessed at baseline and 4 and 8 weeks postintervention. RESULTS Enrollment began in November 2022, with 28 participants currently enrolled. We anticipate recruitment will be completed in 2024. The primary endpoint is a change in ISI score from baseline to 8 weeks postintervention. The secondary endpoint is change in mood symptoms (POMS-SF) from baseline to 8 weeks postintervention. Change scores will be treated as continuous variables. Primary analyses will use ANOVA methods. A within-subjects analysis will examine if the STEP-YA intervention is associated with significant changes in insomnia and mood over time. A 2-way ANOVA will be used to evaluate the utility of coaching sessions to improve treatment effects. CONCLUSIONS Chronic insomnia has significant negative effects on YACS' medical, educational, and psychological functioning. STEP-YA aims to address their needs; study results will determine if the intervention warrants future effectiveness and dissemination studies and if individualized coaching is necessary for adequate treatment response. TRIAL REGISTRATION ClinicalTrials.gov NCT05358951: https://clinicaltrials.gov/study/NCT05358951. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/52315.
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Affiliation(s)
- Alexis L Michaud
- Perini Family Survivors' Center, Dana Farber Cancer Institute, Boston, MA, United States
- Department of Psychology, Suffolk University, Boston, MA, United States
| | - Briana Bice
- Perini Family Survivors' Center, Dana Farber Cancer Institute, Boston, MA, United States
| | - Eva Miklos
- Perini Family Survivors' Center, Dana Farber Cancer Institute, Boston, MA, United States
| | - Katherine McCormick
- Perini Family Survivors' Center, Dana Farber Cancer Institute, Boston, MA, United States
| | | | - Eric S Zhou
- Perini Family Survivors' Center, Dana Farber Cancer Institute, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
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Morgenthaler TI, Kolla BP, Anderson SE, Wahl A, Clark P, Smith JM, Luedke TC, McColley S, Phillips SA, Harper SB, Boudreau NB, Monson AJ. Development and acceptability of a mobile health application integrated with the electronic heath record for treatment of chronic insomnia disorder. J Clin Sleep Med 2022; 18:2785-2792. [PMID: 35959953 PMCID: PMC9713915 DOI: 10.5664/jcsm.10218] [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: 02/08/2022] [Revised: 07/19/2022] [Accepted: 07/20/2022] [Indexed: 12/14/2022]
Abstract
STUDY OBJECTIVES To describe the development and feasibility of a cognitive behavioral therapy for insomnia (CBT-I) program delivered via personal digital devices and fully integrated with the electronic health record (EHR). METHODS A multidisciplinary team of clinicians and members of our Center for Digital Health collaborated to develop a Chronic Insomnia Interactive Care Plan (ChI-ICP), an application that provides personalized and just in time education and promotes self-management using CBT-I concepts, and is activated from and fully integrated into the EHR. Following development, we evaluated patient engagement and workflows, assessed changes to provider workload, and examined outcomes on measures of insomnia during a pilot deployment of the application. RESULTS A total of 222 patients were enrolled and 179 engaged with the plan during the 3-month pilot program. Enrolled patients generated an average of 3.9 ± 2.3 In Basket messages, most being automated notifications related to noncompletion of assigned tasks, while only a few were related to patients requesting additional training or help with insomnia. Sleep efficiency improved from baseline until the completion of the program from 74.5% ± 16.7% to 87.6% ± 10.8% (P = .001), and the Insomnia Severity Index improved from 14.9 ± 5.22 to 11.6 ± 4.80 (P = .006). CONCLUSIONS In this pilot implementation of an integrated ChI-ICP, patient engagement was favorable, workflows and workload were not significantly burdensome for the care teams, and initial evaluation of efficacy was favorable. This provides evidence for an application that is a scalable method to assist patients with chronic insomnia and future work should assess its efficacy in controlled trials. CITATION Morgenthaler TI, Kolla BP, Anderson SE, et al. Development and acceptability of a mobile health application integrated with the electronic heath record for treatment of chronic insomnia disorder. J Clin Sleep Med. 2022;18(12):2785-2792.
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Affiliation(s)
- Timothy I. Morgenthaler
- Center for Sleep Medicine, Mayo Clinic, Rochester, Minnesota
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota
| | - Bhanu Prakash Kolla
- Center for Sleep Medicine, Mayo Clinic, Rochester, Minnesota
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
| | - Sandra E. Anderson
- Center for Sleep Medicine, Mayo Clinic, Rochester, Minnesota
- Department of Nursing, Mayo Clinic, Rochester, Minnesota
| | - Adam Wahl
- Center for Sleep Medicine, Mayo Clinic, Rochester, Minnesota
- Department of Nursing, Mayo Clinic, Rochester, Minnesota
| | - Patrick Clark
- Center for Sleep Medicine, Mayo Clinic, Rochester, Minnesota
- Department of Nursing, Mayo Clinic, Rochester, Minnesota
| | - Justin M. Smith
- Department of Nursing, Mayo Clinic, Rochester, Minnesota
- Center for Digital Health, Mayo Clinic, Rochester, Minnesota
| | | | - Samantha McColley
- Clinical Informatics and Practice Support, Mayo Clinic, Rochester, Minnesota
| | | | - Sarah B. Harper
- Center for Digital Health, Mayo Clinic, Rochester, Minnesota
| | - Nancy B. Boudreau
- Health Education and Content Services, Mayo Clinic, Rochester, Minnesota
| | - Amanda J. Monson
- Center for Sleep Medicine, Mayo Clinic, Rochester, Minnesota
- Department of Nursing, Mayo Clinic, Rochester, Minnesota
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Spencer TL, Watts L, Soni A, Pinedo-Villanueva R, Heegaard AM, Boyce AM, Javaid MK. Neuropathic-like Pain in Fibrous Dysplasia/McCune-Albright Syndrome. J Clin Endocrinol Metab 2022; 107:e2258-e2266. [PMID: 35262711 PMCID: PMC9113795 DOI: 10.1210/clinem/dgac120] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT Pain is a major symptom in adults with fibrous dysplasia/McCune-Albright syndrome (FD/MAS) and response to current treatments, including bisphosphonates and standard analgesics (nonsteroidal anti-inflammatory drugs and opiates) is unpredictable. No studies have explored whether the type of pain is variable in this patient group. OBJECTIVE To determine the frequency of neuropathic-like pain in patients with FD/MAS. DESIGN Retrospective, dual registry study. SETTING Community. PATIENTS FD/MAS online registries: the US-based Familial Dysautonomia Foundation (FDF) and the UK-based Rare and Undiagnosed Diseases (RUDY) study. INTERVENTION Subjects completed questionnaires to evaluate the presence of features of neuropathic-like pain (painDETECT) and the impact on sleep quality (Pittsburgh Sleep Quality Index) and mental health (Hospital Anxiety and Depression Scale). Descriptive statistics were used to characterize the prevalence and associated burden of neuropathic-like pain. MAIN OUTCOME MEASURES Incidence of neuropathic, nociceptive, and unclear pain. RESULTS Of 249 participants, one third experienced neuropathic-like pain. This group had statistically significantly (P < 0.001) worse mental well-being and sleep in comparison to those with predominately nociceptive pain. CONCLUSIONS Neuropathic-like pain is common in patients with FD/MAS and associated with worse quality of life. Evaluation of pain in patients with FD/MAS should include assessment of neuropathic-like pain to guide personalized approaches to treatment and inform future research.
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Affiliation(s)
- Tiahna L Spencer
- Skeletal Disorders and Mineral Homeostasis Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA
| | - Laura Watts
- Department of Metabolism, Digestion and Reproduction, Imperial College London, Hammersmith Campus, Du Cane Road, London, UK
| | - Anushka Soni
- Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Rafael Pinedo-Villanueva
- Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Anne-Marie Heegaard
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | - Alison M Boyce
- Metabolic Bone Disorders Unit, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA
| | - M Kassim Javaid
- Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
- Correspondence: Muhammad K. Javaid, PhD, Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, OX4 2UH, UK.
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Miller MB, Carpenter RW, Freeman LK, Curtis AF, Yurasek AM, McCrae CS. Cannabis use as a moderator of cognitive behavioral therapy for insomnia. J Clin Sleep Med 2021; 18:1047-1054. [PMID: 34870584 DOI: 10.5664/jcsm.9796] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Cannabis use is common among young adults and has been proposed as a potential treatment for insomnia. However, controlled studies examining the impact of cannabis use on insomnia symptoms are rare. This secondary analysis of published trial data tested cannabis use during cognitive behavioral treatment for insomnia (CBT-I) as a moderator of treatment efficacy. METHODS Young adults (ages 18-30 years) who reported past-month binge drinking (4/5+ drinks for women/men) and met DSM-5 and research diagnostic criteria for Insomnia Disorder were randomized to CBT-I (n=28) or sleep hygiene (SH; n=28). Interaction effects were tested using multilevel models. Outcomes included insomnia severity, actigraphy-assessed sleep efficiency, diary-assessed sleep quality, drinking quantity, and alcohol-related consequences. RESULTS Twenty-six participants (46%; 12 SH and 14 CBT-I) reported using cannabis during the treatment phase of the study, on an average of 23% of treatment days (range=3-100%). Relative to those who did not use cannabis, participants who used cannabis during treatment reported heavier drinking and more frequent cigarette use. Approximately 1 in 4 cannabis users (27%) reported using cannabis to help with sleep; however, cannabis and non-cannabis users did not differ in use of alcohol as a sleep aid. Controlling for sex, race, drinking quantity, cigarette use, symptoms of depression, and symptoms of anxiety, use of cannabis during treatment did not moderate CBT-I effects on insomnia severity (b= -.002, p=.99) or other outcomes (all p >.20). CONCLUSIONS CBT-I is effective in reducing insomnia symptoms among young adult drinkers with insomnia, regardless of cannabis use. CLINICAL TRIAL REGISTRATION Registry: ClinicalTrials.gov; Identifier: NCT03627832.
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Affiliation(s)
- Mary Beth Miller
- Department of Psychiatry, University of Missouri School of Medicine, Columbia, MO
| | - Ryan W Carpenter
- Department of Psychological Sciences, University of Missouri-St. Louis, St. Louis, MO
| | - Lindsey K Freeman
- Department of Psychiatry, University of Missouri School of Medicine, Columbia, MO.,Department of Psychological Sciences, University of Missouri, Columbia, MO
| | - Ashley F Curtis
- Department of Psychiatry, University of Missouri School of Medicine, Columbia, MO.,Department of Psychological Sciences, University of Missouri, Columbia, MO
| | - Ali M Yurasek
- Health Education and Behavior Department, College of Health and Human Performance, University of Florida, Gainesville, FL
| | - Christina S McCrae
- Department of Psychiatry, University of Missouri School of Medicine, Columbia, MO
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Su Y, Wang SB, Zheng H, Tan WY, Li X, Huang ZH, Hou CL, Jia FJ. The role of anxiety and depression in the relationship between physical activity and sleep quality: A serial multiple mediation model. J Affect Disord 2021; 290:219-226. [PMID: 34004404 DOI: 10.1016/j.jad.2021.04.047] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 01/12/2021] [Accepted: 04/25/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Physical inactivity exacerbates poorer sleep quality, but potential underlying mechanisms of this association remain unknown. The present study aims to disentangle the pathways linking psychical activity to sleep quality through the serial mediation effect of anxiety and depression in a Chinese population. METHODS Data analyzed were from Guangdong Sleep and Psychosomatic Health Survey, a cross-sectional population-based study with a representative sample of adult inhabitants aged 18-85 years living in Guangdong province, China. A total of 13,768 participants were included with the response rate of 80.4%. Singe and serial mediation analyses were conducted to examine whether anxiety and depression mediated the relationship between physical activity and sleep quality, independently and jointly. RESULTS Both direct and indirect effects of physical activity on sleep quality were found. As predicted, anxiety and depression mediated the relationship between physical activity and sleep quality (B Anxiety = -0.17, 95% bootstrap CI: -0.20 to -0.15; B Depression= -0.25, 95% bootstrap CI: -0.28 to -0.21), respectively. In addition, serial mediation analyses indicated that the association of physical activity and sleep quality is mediated by anxiety and depression in a sequential manner (B = -0.13, 95% bootstrap CI: -0.15 to -0.11). LIMITATIONS The primary limitation of the study is the cross-sectional design, which limits the causal inference ability. CONCLUSIONS These findings highlight the role of anxiety and depression as serial mediators of the relationship between physical activity and sleep quality. Thus, exercise-based programs focusing on improving sleep could benefit from a multi-faceted approach therapeutically targeting psychiatric disorders.
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Affiliation(s)
- Yingying Su
- School of Public Health, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Shi-Bin Wang
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong province, China
| | - Huirong Zheng
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong province, China
| | - Wen-Yan Tan
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong province, China
| | - Xueli Li
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong province, China
| | - Zhuo-Hui Huang
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong province, China
| | - Cai-Lan Hou
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong province, China; School of Medicine, South China University of Technology, Guangzhou, Guangdong province, China
| | - Fu-Jun Jia
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong province, China; School of Medicine, South China University of Technology, Guangzhou, Guangdong province, China.
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Ekholm B, Spulber S, Adler M. A randomized controlled study of weighted chain blankets for insomnia in psychiatric disorders. J Clin Sleep Med 2021; 16:1567-1577. [PMID: 32536366 DOI: 10.5664/jcsm.8636] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
STUDY OBJECTIVES This study aimed to evaluate the effect of weighted chain blankets on insomnia and sleep-related daytime symptoms for patients with major depressive disorder, bipolar disorder, generalized anxiety disorder, and attention deficit hyperactivity disorder. METHODS One hundred twenty patients were randomized (1:1) to either a weighted metal chain blanket or a light plastic chain blanket for 4 weeks. The outcome was evaluated using the Insomnia Severity Index as primary outcome measure and day and night diaries, Fatigue Symptom Inventory, and Hospital Anxiety and Depression Scale as secondary outcome measures. Sleep and daytime activity levels were evaluated by wrist actigraphy. RESULTS At 4 weeks, there was a significant advantage in Insomnia Severity Index ratings of the weighted blanket intervention over the light blanket (P < .001) with a large effect size (Cohen's d 1.90). The intervention by the weighted blanket resulted in a significantly better sleep-maintenance, a higher daytime activity level, and reduced daytime symptoms of fatigue, depression, and anxiety. No serious adverse events occurred. During a 12-month open follow-up phase of the study, participants continuing to use weighted blankets maintained the effect on sleep, while patients switching from a light to a weighted blanket experienced an effect on Insomnia Severity Index ratings similar to that of participants using the weighted blanket from the beginning. CONCLUSIONS Weighted chain blankets are an effective and safe intervention for insomnia in patients with major depressive disorder, bipolar disorder, generalized anxiety disorder, or attention deficit hyperactivity disorder, also improving daytime symptoms and levels of activity. CLINICAL TRIAL REGISTRATION Registry: ClinicalTrials.gov; Name: Controlled Study of Chain Blanket for Insomnia; URL: https://clinicaltrials.gov/ct2/show/NCT03546036; Identifier: NCT03546036.
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Affiliation(s)
- Bodil Ekholm
- The Affective Disorder Outpatient Clinic at Psychiatry Southwest, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Stefan Spulber
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Mats Adler
- The Affective Disorder Outpatient Clinic at Psychiatry Southwest, Karolinska University Hospital Huddinge, Stockholm, Sweden.,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Effectiveness of App-Based Yoga of Immortals (YOI) Intervention for Insomnia in Asian Population during Pandemic Restrictions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115706. [PMID: 34073407 PMCID: PMC8199123 DOI: 10.3390/ijerph18115706] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 05/23/2021] [Accepted: 05/24/2021] [Indexed: 12/29/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic created significant psychological challenges worldwide, including stress, emotional distress, and insomnia. In addition, social distancing, travel restrictions, and spread of disease have resulted in unique challenges, creating barriers to healthcare access. Compared to the rate prior to the COVID-19 pandemic, a significant increase in clinical insomnia rates have been reported. With well-known limitations of currently established treatments (e.g., cognitive behavioral therapy-insomnia (CBT-I), pharmacotherapy), there is a need to explore other effective and safe treatment modalities to treat insomnia, especially those that can be used remotely. The purpose of this study is to assess the effectiveness of app-based intervention to treat insomnia in the current era of the COVID-19 pandemic (using the Yoga of Immortals (YOI) app). This prospective cohort study was approved by the Institutional Review Board. All participants in this study were asked to complete an online survey including demographic data and validated Insomnia Severity Index (ISI) at baseline (15 May 2020), 4 weeks, and 8 weeks after starting the YOI intervention. Survey data was exported using Microsoft Excel. Statistical analysis was done using the GraphPad Prism 8. YOI intervention significantly improved the mean ISI scores in all categories of insomnia (severe, moderate, and subthreshold) at each follow-up (p ≤ 0.0001). The improvement was significant among all age groups and in both genders. In our study, YOI was a novel and effective intervention for improving insomnia symptoms and may be a new addition to the armamentarium of insomnia management. Being app-based, this has potential wider applicability, especially during the current COVID-19 pandemic.
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Da Costa D, Lai JK, Zelkowitz P. A prospective study on the course of sleep disturbances in first-time fathers during the transition to parenthood. Infant Ment Health J 2021; 42:222-232. [PMID: 33491788 DOI: 10.1002/imhj.21911] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
INTRODUCTION This study examined sleep disturbances in first-time fathers from the third trimester of their partner's pregnancy to 2 months postpartum to determine prevalence, incidence, and persistence of sleep disturbances and identify associated determinants. METHODS Men expecting their first child were recruited from local prenatal classes and university-affiliated obstetric clinics. During their partner's third trimester of pregnancy and 2 months postpartum, 459 men completed standardized online self-report questionnaires measuring sociodemographics, lifestyle, and psychosocial variables and sleep quality. RESULTS Disturbed sleep (Pittsburgh Sleep Quality Index [PSQI] global score >5) increased from 29.6% during the third trimester to 44.7% at 2 months postpartum. The incidence of poor sleep at 2 months postpartum was 33.7%. Among men with disturbed sleep at the antenatal assessment, 70.6% continued to have sleep disturbances at 2 months postpartum. An increase in depressive symptoms and higher parenting stress was independently associated with onset and persistence of disturbed sleep at 2 months postpartum. CONCLUSIONS Sleep is compromised in expectant and new fathers. Strategies aimed at improving sleep, depressed mood, and managing the challenges of parenting may be important components to include in prenatal interventions aimed at enhancing the transition to parenthood and infant development.
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Affiliation(s)
- Deborah Da Costa
- Department of Medicine, McGill University, Montreal, Quebec, Canada.,Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Jonathan K Lai
- Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Phyllis Zelkowitz
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada.,Department of Psychiatry, Jewish General Hospital, Montreal, Quebec, Canada
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12
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Suraev AS, Marshall NS, Vandrey R, McCartney D, Benson MJ, McGregor IS, Grunstein RR, Hoyos CM. Cannabinoid therapies in the management of sleep disorders: A systematic review of preclinical and clinical studies. Sleep Med Rev 2020; 53:101339. [DOI: 10.1016/j.smrv.2020.101339] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 04/13/2020] [Accepted: 04/14/2020] [Indexed: 12/21/2022]
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13
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Wen Q, Dong X, Lan L, Liu L, Tumilty S, Yan B, Chen Y, Wang X, Zhang Y, Feng F. Traditional Chinese herbal bath therapy for insomnia: A protocol for systematic review. Medicine (Baltimore) 2020; 99:e21166. [PMID: 32702872 PMCID: PMC7373592 DOI: 10.1097/md.0000000000021166] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 06/08/2020] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION Insomnia is a major public health problem. Due to the side effects of pharmacological therapy, people are seeking to choose complementary and alternative therapies for insomnia disorder. Traditional Chinese herbal bath therapy is an important complementary therapy which combines advantages of Chinese herbs and bathing therapy. This protocol describes the methodology of a systematic review assessing the effectiveness and safety of traditional Chinese herbal bath therapy for insomnia. METHODS AND ANALYSIS Reporting of this review will be adherent to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. We will electronically search the following seven databases from inception to January 23, 2020: PubMed, Cochrane database (CENTRAL), EMBASE, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), VIP Database, and Wanfang Database. Parallel randomized controlled trials evaluating the effectiveness and safety of traditional Chinese herbal bath therapy for insomnia will be included. Study selection, data extraction and assessment of risk of bias will be performed independently by two researchers. The sleep quality will be assessed as the primary outcome. Global symptom improvement, anxiety and depression, and adverse events will be evaluated as secondary outcomes. The Cochrane's risk of bias tool will be utilized for assessing the methodological quality of included studies. Revman software (v.5.3) will be used for data synthesis and statistical analysis. Data will be synthesized by either fixed-effects or random-effects model according to a heterogeneity test. If it is not appropriate for a meta-analysis, a descriptive analysis will be conducted. GRADE system will be used to assess the quality of evidence. PROSPERO REGISTRATION NUMBER CRD42020168507.
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Affiliation(s)
- Qiao Wen
- Acupuncture and Tuina School, The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiaohui Dong
- Acupuncture and Tuina School, The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Lei Lan
- Acupuncture and Tuina School, The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Lizhou Liu
- Centre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Steve Tumilty
- Centre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Bohua Yan
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu
| | - Yabing Chen
- Acupuncture and Tuina School, The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xing Wang
- Santai County Hospital of Traditional Chinese Medicine, Santai County
| | - Yonggang Zhang
- Department of Periodical Press and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Fen Feng
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu
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14
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Jallow AW, Wang MH, Ho YS. Global research trends and publications of insomnia: A bibliometric analysis. COLLNET JOURNAL OF SCIENTOMETRICS AND INFORMATION MANAGEMENT 2020. [DOI: 10.1080/09737766.2021.1906184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Amadou W. Jallow
- Department of Biotechnology, College of Health Science, Asia University, No. 500, Lioufeng Road, Wufeng, Taichung 41354, Taiwan, R.O.C
| | - Ming-Huang Wang
- Trend Research Centre, Asia University, No. 500, Lioufeng Road, Wufeng, Taichung 41354, Taiwan, R.O.C
| | - Yuh-Shan Ho
- Trend Research Centre, Asia University, No. 500, Lioufeng Road, Wufeng, Taichung 41354, Taiwan, R.O.C
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15
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Birling Y, Jia M, Li G, Sarris J, Bensoussan A, Zhu X. Zao Ren An Shen for insomnia: a systematic review with meta-analysis. Sleep Med 2020; 69:41-50. [DOI: 10.1016/j.sleep.2019.12.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 09/06/2019] [Accepted: 12/23/2019] [Indexed: 12/17/2022]
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16
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Bethea TN, Zhou ES, Schernhammer ES, Castro-Webb N, Cozier YC, Rosenberg L. Perceived racial discrimination and risk of insomnia among middle-aged and elderly Black women. Sleep 2020; 43:zsz208. [PMID: 31555803 PMCID: PMC6955644 DOI: 10.1093/sleep/zsz208] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 06/26/2019] [Indexed: 12/17/2022] Open
Abstract
STUDY OBJECTIVE To assess whether perceived racial discrimination is associated with insomnia among Black women. METHODS Data on everyday and lifetime racism and insomnia symptoms were collected from questionnaires administered in the Black Women's Health Study, an ongoing prospective cohort of Black women recruited in 1995 from across the United States. In 2009, participants completed five questions on the frequency of discriminatory practices in daily life (everyday racism) and six questions on ever experiencing unfair treatment in key institutional contexts (lifetime racism). In 2015, the Insomnia Severity Index was used to assess insomnia symptoms. We estimated odds ratios and 95% confidence intervals for associations of racism with insomnia, using multivariable logistic regression models adjusted for potential confounders. RESULTS The 26 139 participants in the analytic sample were 40-90 years old (median = 57 years, SD = 9.6 years). Higher levels of everyday racism and lifetime racism were positively associated with subthreshold (ptrend < .01) and clinical insomnia (ptrend < .01). Results remained unchanged after further adjustment for sleep duration and shift work. CONCLUSIONS Higher levels of perceived racism were associated with increased odds of insomnia among middle-aged and elderly Black women. Thus, perceived racism may contribute to multiple racial health disparities resulting from insomnia. Helping minority populations cope with their experiences of discrimination may decrease the significant public health impact of sleep disruption and subsequent diagnoses.
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Affiliation(s)
- Traci N Bethea
- Slone Epidemiology Center, Boston University, Boston, MA
- Department of Medicine, Boston University School of Medicine, Boston, MA
| | - Eric S Zhou
- Dana-Farber Cancer Institute, Boston, MA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA
| | - Eva S Schernhammer
- Department of Medicine, Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, MA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
- Department of Epidemiology, Medical University of Vienna, Vienna, Austria
| | | | - Yvette C Cozier
- Slone Epidemiology Center, Boston University, Boston, MA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA
| | - Lynn Rosenberg
- Slone Epidemiology Center, Boston University, Boston, MA
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Abstract
Insomnia is a state defined as trouble with sleep; it is a chronically disabling condition and is now significantly prevalent, imposing enormous health and economic burdens both on individuals and on society. This state includes trouble in falling asleep, problems staying asleep, fragmented sleep (repeatedly awakening at night), and/or awakening before time in the morning. This difficulty in sleeping causes feeling exhausted during the day and trouble with daytime activities including driving, family responsibilities, and completion of valued daily routines. Different types of synthetic sedative drugs are used to handle nervous system changes, but repeated use of sedatives caused tolerance in the human body. After a while, people had to take a heavy dose of sedative to make them feel sleepy, which imposes extra toxic effects on vital organs of the body. Medicinal plants are gaining more and more attention as sedative agents because herbs contained different types of natural bioactive metabolites with not well reported side effects. In addition, medicinal plants have economic, high efficacy and are easy available. So in current review plants possessing sedative activities have been compiled with their constituents responsible to manage insomnia. Review of the literature indicated that medicinal plants from various systems of medicine have been reported to possess sedative activity. This review suggests that medicinal plants are efficacious for insomnia; further laboratory and clinical studies are required.
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18
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A G, Li X, Su B, Lian H, Bao M, Liang Y, Chen Y, Jia Y, Bao L, Su X. Effect of Mongolian warm acupuncture on the gene expression profile of rats with insomnia. Acupunct Med 2019; 37:301-311. [PMID: 31225736 DOI: 10.1136/acupmed-2016-011243] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND The mechanism of Mongolian warm acupuncture (MWA) for the treatment of insomnia has not been previously reported. OBJECTIVE To investigate the effect of MWA on gene expression profile in the p-chlorophenylalanine (PCPA)-induced rat model of insomnia. METHODS A rat model of insomnia was established and the animals were divided into five groups: control, PCPA (untreated), PCPA+estazolam, PCPA+MA (manual acupuncture), and PCPA+MWA. The rats were euthanased at 7 days after treatment, and hypothalamic tissue was harvested to extract total RNA for the analysis of gene expression profile. Micro-array and Partek Genomics Suite analysis system were used to analyse differential expression of genes between groups. Furthermore, ingenuity pathways analysis was used to analyse the main regulators. RESULTS After treatment, in rats with improved sleep, micro-array data from the follow-up phase compared with baseline showed that MWA down-regulated 11 genes compared with the control group and 16 genes compared with the PCPA group. Six genes were selected following the micro-array detection to perform quantitative polymerase chain reaction (qPCR) verification, and the results showed that the coincidence rate was up to 90%, which verified the reliability of the microarray results. Compared with the PCPA group, transcription levels of Egr 1, Btg2 and BDNF in the PCPA+MWA group were up-regulated (P<0.05). CONCLUSION In combination, the findings of this study suggests that MWA is efficacious at improving sleep in an experimental rat model of insomnia.
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Affiliation(s)
- Gula A
- Inner Mongolia Medical University, Hohhot, China
| | - Xian Li
- Clinical Medicine Research Center of Affiliated Hospital, Inner Mongolia Medical University, Hohhot, China
| | - Budao Su
- Inner Mongolia Medical University, Hohhot, China
| | - Hua Lian
- Inner Mongolia Medical University, Hohhot, China
| | - Manjie Bao
- Inner Mongolia Medical University, Hohhot, China
| | - Yabin Liang
- Clinical Medicine Research Center of Affiliated Hospital, Inner Mongolia Medical University, Hohhot, China
| | | | - Yongfeng Jia
- Inner Mongolia Medical University, Hohhot, China
| | - Lidao Bao
- Inner Mongolia Medical University, Hohhot, China
| | - Xiulan Su
- Clinical Medicine Research Center of Affiliated Hospital, Inner Mongolia Medical University, Hohhot, China
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Kaldo V, Bothelius K, Blom K, Lindhe M, Larsson M, Karimi K, Melder S, Bondestam V, Ulfsparre C, Sternbrink K, Jernelöv S. An open‐ended primary‐care group intervention for insomnia based on a self‐help book – A randomized controlled trial and 4‐year follow‐up. J Sleep Res 2019; 29:e12881. [DOI: 10.1111/jsr.12881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 05/01/2019] [Accepted: 05/08/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Viktor Kaldo
- Centre for Psychiatry Research Department of Clinical Neuroscience Karolinska Institutet, & Stockholm Health Care Services Stockholm County Council, M58 Karolinska University Hospital Huddinge Stockholm Sweden
- Department of Psychology Faculty of Health and Life Sciences Linnaeus University Växjö Sweden
| | | | - Kerstin Blom
- Centre for Psychiatry Research Department of Clinical Neuroscience Karolinska Institutet, & Stockholm Health Care Services Stockholm County Council, M58 Karolinska University Hospital Huddinge Stockholm Sweden
- Division of Psychiatry Haukeland University Hospital Bergen Norway
| | - Maria Lindhe
- Department of Psychology Stockholm University Stockholm Sweden
- Gustavsbergs Primary Care Centre Stockholm Health Care Services Stockholm County Council Stockholm Sweden
| | - Matilda Larsson
- Department of Psychology Stockholm University Stockholm Sweden
- Gustavsbergs Primary Care Centre Stockholm Health Care Services Stockholm County Council Stockholm Sweden
| | - Kobra Karimi
- Department of Psychology Stockholm University Stockholm Sweden
| | - Susanne Melder
- Department of Psychology Stockholm University Stockholm Sweden
| | | | | | - Klara Sternbrink
- Gustavsbergs Primary Care Centre Stockholm Health Care Services Stockholm County Council Stockholm Sweden
| | - Susanna Jernelöv
- Centre for Psychiatry Research Department of Clinical Neuroscience Karolinska Institutet, & Stockholm Health Care Services Stockholm County Council, M58 Karolinska University Hospital Huddinge Stockholm Sweden
- Division of Psychology Department of Clinical Neuroscience Karolinska Institutet Stockholm Sweden
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20
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Partner-assisted cognitive behavioural therapy for insomnia versus cognitive behavioural therapy for insomnia: a randomised controlled trial. Trials 2019; 20:262. [PMID: 31068225 PMCID: PMC6506966 DOI: 10.1186/s13063-019-3334-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 03/28/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Insomnia is a prevalent sleep disorder associated with significant economic and personal burdens. Cognitive behavioural therapy for insomnia (CBTI) is considered the gold standard intervention for insomnia and its efficacy has been well demonstrated. However, the core treatment strategies of CBTI require significant behavioural change, which many individuals find challenging. As a result, although CBTI is efficacious, its effectiveness is reduced by modest levels of adherence in typical clinical settings. This is problematic as adherence is essential to attain desired treatment outcomes. Sleep is often a dyadic process, with approximately 60% of Australian adults sharing a bed. Hence, the present study aims to determine whether incorporating bed partners into treatment for insomnia increases treatment adherence and completion. The impact of adherence on symptoms of insomnia will also be examined. METHODS This study is a mixed-effects randomised effectiveness trial of partner-assisted CBTI (PA-CBTI). It is an "effectiveness" (as opposed to "efficacy") trial, due to the focus on "real world" clinic-based clients and adherence/attrition as outcomes. Participants will include 120 clients with insomnia who are randomly assigned, in equal numbers, to PA-CBTI, traditional individual CBTI (i-CBTI), or partner-assisted sleep management therapy (PA-SMT; which serves as the control group). All interventions consist of seven weekly 1-h sessions. Treatment outcome is evaluated using clinician-rated treatment adherence, and diary-based adherence to stimulus control and sleep restriction. Clients and partners complete major assessments at pre- and post-treatment, and at 6-month follow-up. Secondary outcome variables include actigraphy, self-report measures related to sleep, comorbid psychopathology, and relationship functioning. DISCUSSION This is the first randomised clinical trial to examine the impact of incorporating the bed partner in the treatment of insomnia. Results will provide new information about the role partners play in clients' insomnia presentation and treatment response, and better define the role of adherence in CBTI. This trial has the potential to optimise treatment outcomes for insomnia by improving adherence and reducing attrition. Results could have far-reaching impacts. Improvements in insomnia have been linked to improvements in mental and physical health and, given the high financial costs of insomnia, this study could have a positive economic impact. TRIAL REGISTRATION ACTRN, ACTRN12616000586415 . Registered on 5 May 2016.
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21
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Madsen MT, Huang C, Zangger G, Zwisler ADO, Gögenur I. Sleep Disturbances in Patients With Coronary Heart Disease: A Systematic Review. J Clin Sleep Med 2019; 15:489-504. [PMID: 30853047 DOI: 10.5664/jcsm.7684] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 01/08/2019] [Indexed: 12/19/2022]
Abstract
STUDY OBJECTIVES Investigation into sleep and coronary heart disease (CHD) has predominantly been focused on sleep disturbances as a risk factor for developing CHD. Objectively measured and self-reported sleep at a patient level has only been sparsely and not systematically reported. Therefore, we set out to review the literature for studies using objectively measured and self-reported sleep in patients with CHD. The review focuses on patients with acute coronary syndrome (ACS) and stable CHD. METHODS A systematic review performed in four databases adhering to the PRISMA guidelines applying a qualitative synthesis of evidence. RESULTS Following ACS, we found sleep architecture to be significantly disturbed with changes normalizing over a period of up to 6 months. With increasing severity of CHD, sleep disturbances were more pronounced; however, the modulating effects of sleep-disordered breathing and ejection fraction on sleep in patients with CHD are conflicting. Overall, studies were predominantly cross-sectional in design and of low methodological quality. Polysomnography was the predominant outcome assessment tool and validated self-reported assessment tools were limited. CONCLUSIONS Future investigations in sleep and CHD applying both a longitudinal design and investigating objective and self-reported sleep assessments are warranted. SYSTEMATIC REVIEW REGISTRATION Registry: PROSPERO, Title: Sleep measures in relation to coronary heart disease: a systematic review, Identifier: CRD42017056377, URL: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=56377.
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Affiliation(s)
- Michael Tilling Madsen
- Center for Surgical Science, Zealand University Hospital, Denmark.,Department of Emergency, Zealand University Hospital, Denmark
| | - Chenxi Huang
- Center for Surgical Science, Zealand University Hospital, Denmark
| | - Graziella Zangger
- REHPA - Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital and University of Southern Denmark, Denmark
| | - Ann Dorthe Olsen Zwisler
- REHPA - Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital and University of Southern Denmark, Denmark
| | - Ismail Gögenur
- Center for Surgical Science, Zealand University Hospital, Denmark
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22
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Wang L, Wang K, Liu JH, Wang YP. Altered Default Mode and Sensorimotor Network Connectivity With Striatal Subregions in Primary Insomnia: A Resting-State Multi-Band fMRI Study. Front Neurosci 2018; 12:917. [PMID: 30574065 PMCID: PMC6291517 DOI: 10.3389/fnins.2018.00917] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 11/22/2018] [Indexed: 11/15/2022] Open
Abstract
Background: Primary insomnia is a high prevalent sleep disorder. Disturbed brain activity during reward, emotional, and cognitive processing have been observed in insomnia patients. Studies have implicated a critical role of the striatum in these dysfunctions. However, there have been no direct investigations on the whole-brain functional connectivity (FC) of the striatum in insomnia. Methods: We analyzed the group differences in the FC images of 6 predefined striatal subregions based on the multi-band resting-state fMRI data of 18 insomnia patients and 16 healthy controls. Results: We found increased positive FC in the bilateral medial frontal gyrus for bilateral dorsal caudate (DC) and left inferior ventral striatum (VS) subregions, but increased negative FC in the bilateral inferior parietal lobe for the left inferior VSi and right dorsal caudal putamen (DCP) subregions, and in the lateral temporal, occipital, and primary sensorimotor areas for the bilateral DC and left superior VS subregions. The FC between the right DCP and right inferior parietal lobe showed significant positive correlation with Pittsburgh Sleep Quality Index (PSQI). Conclusion: The findings indicate disturbed striatal FC with the default mode network (DMN), the visual and somatosensory areas in insomnia, which likely reflects an inappropriate reward or emotional significance attribute to self-reflection, episodic memory, sensory-perception processes. The altered striatal FC might increase the risk of insomnia patients to develop depression and anxiety.
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Affiliation(s)
- Li Wang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Kun Wang
- Beijing Puren Hospital, Beijing, China
| | - Jiang-Hong Liu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yu-Ping Wang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
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Abstract
BACKGROUND Insomnia is a public sleep disorder defined as a deficiency of sleep quantity or quality. Acupressure is a low-cost treatment that has potential as an insomnia therapy. METHODS Four databases will be searched from inception to date. The researchers will screen clinical randomized trials of acupressure and auricular acupuncture for insomnia. The screening of the study, data extraction will be carried out independently by 2 researchers. The specific process will refer to the Cochrane Handbook for Systematic Review. RESULTS The results of the study will be published in a scientific journal after peer-review. We integrate the latest study about acupressure for insomnia. CONCLUSION This systematic review will provide evidence for assessing the improvement of acupressure for insomnia. ETHICS AND DISSEMINATION The systematic review will be published in a peer-reviewed journal. The review will also be disseminated electronically and in print.PROSPERO registration: CRD42018104155.
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Affiliation(s)
- Dong-Jie Wu
- Graduate School, Zhejiang Chinese Medical University, Hangzhou, Zhejiang
- School of Chinese Medicine, Hong Kong Baptist University, Hong Kong
| | - Hai-Cheng Dong
- Department of Tradition Chinese Medicine, Children's Hospital, Zhejiang University School of Medicine, Hangzhou
| | - Tsz-Nga Tang
- Graduate School, Zhejiang Chinese Medical University, Hangzhou, Zhejiang
| | - Shi-Feng Zhu
- Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang, China
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Grayson LP, DeWolfe JL. Sleep Disorders in Epilepsy: Current Trends and Future Perspectives. CURRENT SLEEP MEDICINE REPORTS 2018. [DOI: 10.1007/s40675-018-0110-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Garland SN, Rowe H, Repa LM, Fowler K, Zhou ES, Grandner MA. A decade's difference: 10-year change in insomnia symptom prevalence in Canada depends on sociodemographics and health status. Sleep Health 2018; 4:160-165. [PMID: 29555129 PMCID: PMC6203592 DOI: 10.1016/j.sleh.2018.01.003] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 01/07/2018] [Accepted: 01/21/2018] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Insomnia is recognized as a public health issue. The objectives of this study were to characterize and compare the prevalence of insomnia symptoms in the Canadian population in 2002 and 2012, and to identify sociodemographic and psychosocial predictors of trouble sleeping. METHODS Data from adult participants in the Canadian Community Health Survey-Mental Health cycles 2000-2002 (n = 34,118) and 2011-2012 (n = 23,089) were used. Participants responded to the question "How often do you have trouble going to sleep or staying asleep?", with those who indicated "most of the time" or "all of the time" classified as having insomnia symptoms. Logistic regressions, adjusted for covariates, were used to examine differences between cycles. RESULTS The unadjusted prevalence of insomnia symptoms increased from 15.6% to 17.1% between 2002 and 2012, representing an absolute increase of 1.5%. The likelihood of insomnia symptoms was significantly influenced by age, sex, education, physical health, and mental health status. A 3-way year-age-sex interaction was statistically significant such that women aged 40-59 demonstrated approximately 29% increased likelihood of insomnia symptoms from 2002 to 2012. This was reduced to 24% when adjusted for physical and mental health. There were no significant differences for men across age groups. CONCLUSION Over a 10-year period, the prevalence of insomnia symptoms increased in Canada. This trend appears to be driven in part by greater levels of insomnia symptoms among middle-aged women.
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Affiliation(s)
- Sheila N Garland
- Department of Psychology, Faculty of Science, Memorial University, St. John's, NL, Canada; Division of Oncology, Faculty of Medicine, Memorial University, St. John's, NL, Canada.
| | - Hillary Rowe
- Department of Psychology, Faculty of Science, Memorial University, St. John's, NL, Canada
| | - Lily M Repa
- Department of Psychology, Faculty of Science, Memorial University, St. John's, NL, Canada
| | - Ken Fowler
- Department of Psychology, Faculty of Science, Memorial University, St. John's, NL, Canada
| | - Eric S Zhou
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
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A novel cognitive behavioral treatment for patients with chronic insomnia: A pilot experimental study. Complement Ther Med 2018; 37:61-63. [DOI: 10.1016/j.ctim.2018.01.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 01/29/2018] [Accepted: 01/30/2018] [Indexed: 10/18/2022] Open
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Dong X, Qin H, Wu T, Hu H, Liao K, Cheng F, Gao D, Lei X. Rest but busy: Aberrant resting-state functional connectivity of triple network model in insomnia. Brain Behav 2018; 8:e00876. [PMID: 29484254 PMCID: PMC5822570 DOI: 10.1002/brb3.876] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 10/04/2017] [Accepted: 10/12/2017] [Indexed: 01/01/2023] Open
Abstract
Introduction One classical hypothesis among many models to explain the etiology and maintenance of insomnia disorder (ID) is hyperarousal. Aberrant functional connectivity among resting-state large-scale brain networks may be the underlying neurological mechanisms of this hypothesis. The aim of current study was to investigate the functional network connectivity (FNC) among large-scale brain networks in patients with insomnia disorder (ID) during resting state. Methods In the present study, the resting-state fMRI was used to evaluate whether patients with ID showed aberrant FNC among dorsal attention network (DAN), frontoparietal control network (FPC), anterior default mode network (aDMN), and posterior default mode network (pDMN) compared with healthy good sleepers (HGSs). The Pearson's correlation analysis was employed to explore whether the abnormal FNC observed in patients with ID was associated with sleep parameters, cognitive and emotional scores, and behavioral performance assessed by questionnaires and tasks. Results Patients with ID had worse subjective thought control ability measured by Thought Control Ability Questionnaire (TCAQ) and more negative affect than HGSs. Intriguingly, relative to HGSs, patients with ID showed a significant increase in FNC between DAN and FPC, but a significant decrease in FNC between aDMN and pDMN. Exploratory analysis in patients with ID revealed a significantly positive correlation between the DAN-FPC FNC and reaction time (RT) of psychomotor vigilance task (PVT). Conclusion The current study demonstrated that even during the resting state, the task-activated and task-deactivated large-scale brain networks in insomniacs may still maintain a hyperarousal state, looking quite similar to the pattern in a task condition with external stimuli. Those results support the hyperarousal model of insomnia.
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Affiliation(s)
- Xiaojuan Dong
- Sleep and NeuroImaging CenterFaculty of PsychologySouthwest UniversityChongqingChina
- Key Laboratory of Cognition and Personality of Ministry of EducationChongqingChina
| | - Haixia Qin
- Sleep and NeuroImaging CenterFaculty of PsychologySouthwest UniversityChongqingChina
- Key Laboratory of Cognition and Personality of Ministry of EducationChongqingChina
| | - Taoyu Wu
- School of Psychological and Cognitive SciencesPKU‐IDG/McGovern Institute for Brain ResearchBeijing Key Laboratory of Behavior and Mental HealthPeking UniversityBeijingChina
| | - Hua Hu
- Department of Psychiatrythe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Keren Liao
- Sleep and NeuroImaging CenterFaculty of PsychologySouthwest UniversityChongqingChina
- Key Laboratory of Cognition and Personality of Ministry of EducationChongqingChina
| | - Fei Cheng
- Sleep and NeuroImaging CenterFaculty of PsychologySouthwest UniversityChongqingChina
- Key Laboratory of Cognition and Personality of Ministry of EducationChongqingChina
| | - Dong Gao
- Sleep Psychology CenterDaping HospitalThird Military Medical UniversityChongqingChina
| | - Xu Lei
- Sleep and NeuroImaging CenterFaculty of PsychologySouthwest UniversityChongqingChina
- Key Laboratory of Cognition and Personality of Ministry of EducationChongqingChina
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Zhang H, Deng H, Jia LB, Ai SC. Music electric stimulation of points for anxiety: a multi-center randomized controlled clinical trial. JOURNAL OF ACUPUNCTURE AND TUINA SCIENCE 2018. [DOI: 10.1007/s11726-018-1020-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Zhou ES, Vrooman LM, Manley PE, Crabtree VM, Recklitis CJ. Adapted Delivery of Cognitive-Behavioral Treatment for Insomnia in Adolescent and Young Adult Cancer Survivors: A Pilot Study. Behav Sleep Med 2017; 15:288-301. [PMID: 27077226 DOI: 10.1080/15402002.2015.1126597] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Adolescent and young adult cancer survivors (AYACS) are at risk for the development of insomnia, though it remains vastly undertreated. Limited research has evaluated cognitive-behavioral treatment for insomnia (CBT-I) in AYACS. The present study piloted adapted CBT-I designed to improve treatment accessibility by delivering a three-session intervention in person and via videoconference. AYACS with insomnia (N = 12) enrolled in the study. Ten AYACS completed the intervention, with six in person and four via videoconference. Sleep variables improved immediately postintervention and were sustained at two-month follow-up. Within sample effect sizes of the adapted intervention for sleep, variables were large, and there were no noted differences on sleep outcomes between the in-person and videoconference participants. These pilot findings indicate that an adapted CBT-I intervention is feasible and promising in AYACS populations.
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Affiliation(s)
- Eric S Zhou
- a David B. Perini Jr. Quality of Life Clinic , Dana-Farber Cancer Institute , Boston , Massachusetts.,b Department of Pediatrics, Harvard Medical School , Boston , Massachusetts
| | - Lynda M Vrooman
- a David B. Perini Jr. Quality of Life Clinic , Dana-Farber Cancer Institute , Boston , Massachusetts.,b Department of Pediatrics, Harvard Medical School , Boston , Massachusetts.,c Department of Pediatrics, Boston Children's Hospital , Boston , Massachusetts
| | - Peter E Manley
- b Department of Pediatrics, Harvard Medical School , Boston , Massachusetts.,c Department of Pediatrics, Boston Children's Hospital , Boston , Massachusetts.,d Pediatric Neuro-Oncology Clinic, Dana-Farber Cancer Institute , Boston , Massachusetts
| | - Valerie M Crabtree
- e Department of Psychology, St. Jude Children's Research Hospital , Memphis , Tennessee
| | - Christopher J Recklitis
- a David B. Perini Jr. Quality of Life Clinic , Dana-Farber Cancer Institute , Boston , Massachusetts.,b Department of Pediatrics, Harvard Medical School , Boston , Massachusetts
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Miller CB, Valenti L, Harrison CM, Bartlett DJ, Glozier N, Cross NE, Grunstein RR, Britt HC, Marshall NS. Time Trends in the Family Physician Management of Insomnia: The Australian Experience (2000-2015). J Clin Sleep Med 2017; 13:785-790. [PMID: 28454597 DOI: 10.5664/jcsm.6616] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 03/14/2017] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES To evaluate changes in rates of family physician (FP) management of insomnia in Australia from 2000-2015. METHODS The Bettering the Evaluation And Care of Health (BEACH) program is a nationally representative cross-sectional survey of 1,000 newly randomly sampled family physicians' activity in Australia per year, who each record details of 100 consecutive patient encounters. This provided records of approximately 100,000 encounters each year. We identified all encounters with patients older than 15 years where insomnia or difficulty sleeping was managed and assessed trends in these encounters from 2000-2015. RESULTS There was no change in the management rate of insomnia from 2000-2007 (1.54 per 100 encounters [95% confidence interval [CI]: 1.49-1.58]). This rate was lower from 2008-2015 (1.31 per 100 encounters [95% CI: 1.27-1.35]). There was no change in FP management: pharmacotherapy was used in approximately 90% of encounters; nonpharmacological advice was given at approximately 20%; and onward referral at approximately 1% of encounters. Prescription of temazepam changed from 54.6 [95% CI: 51.4-57.9] per 100 insomnia problems in 2000-2001 to 43.6 [95% CI: 40.1-47.0] in 2014-2015, whereas zolpidem increased steadily from introduction in 2000 to 14.6 [95% CI: 12.2-17.1] per 100 insomnia problems in 2006-2007, and then decreased to 7.3 [95% CI: 5.4-9.2] by 2014-2015. CONCLUSIONS Insomnia management frequency decreased after 2007 in conjunction with ecologically associated Australian media reporting of adverse effects linked to zolpidem use. Australian FPs remain reliant on pharmacotherapy for the management of insomnia.
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Affiliation(s)
- Christopher B Miller
- CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, The University of Sydney, New South Wales, Australia
| | - Lisa Valenti
- Family Medicine Research Centre, School of Public Health, Sydney Medical School, The University of Sydney, New South Wales, Australia
| | - Christopher M Harrison
- Family Medicine Research Centre, School of Public Health, Sydney Medical School, The University of Sydney, New South Wales, Australia
| | - Delwyn J Bartlett
- CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, The University of Sydney, New South Wales, Australia.,Sydney Medical School, The University of Sydney, New South Wales, Australia
| | - Nick Glozier
- Brain and Mind Centre, The University of Sydney, New South Wales, Australia
| | - Nathan E Cross
- CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, The University of Sydney, New South Wales, Australia
| | - Ronald R Grunstein
- CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, The University of Sydney, New South Wales, Australia.,Sydney Medical School, The University of Sydney, New South Wales, Australia.,Department of Respiratory and Sleep Medicine, RPAH, Sydney Local Health District, Sydney, New South Wales, Australia
| | - Helena C Britt
- Family Medicine Research Centre, School of Public Health, Sydney Medical School, The University of Sydney, New South Wales, Australia
| | - Nathaniel S Marshall
- CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, The University of Sydney, New South Wales, Australia.,Sydney Nursing School, The University of Sydney, New South Wales, Australia
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31
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Da Costa D, Allman AA, Libman E, Desormeau P, Lowensteyn I, Grover S. Prevalence and Determinants of Insomnia After a Myocardial Infarction. PSYCHOSOMATICS 2017; 58:132-140. [DOI: 10.1016/j.psym.2016.11.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 11/03/2016] [Accepted: 11/04/2016] [Indexed: 12/12/2022]
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Li S, Tian J, Bauer A, Huang R, Wen H, Li M, Wang T, Xia L, Jiang G. Reduced Integrity of Right Lateralized White Matter in Patients with Primary Insomnia: A Diffusion-Tensor Imaging Study. Radiology 2016; 280:520-8. [PMID: 27045987 DOI: 10.1148/radiol.2016152038] [Citation(s) in RCA: 80] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Purpose To analyze the integrity of white matter (WM) tracts in primary insomnia patients and provide better characterization of abnormal WM integrity and its relationship with disease duration and clinical features of primary insomnia. Materials and Methods This prospective study was approved by the ethics committee of the Guangdong No. 2 Provincial People's Hospital. Tract-based spatial statistics were used to compare changes in diffusion parameters of WM tracts from 23 primary insomnia patients and 30 healthy control (HC) participants, and the accuracy of these changes in distinguishing insomnia patients from HC participants was evaluated. Voxel-wise statistics across subjects was performed by using a 5000-permutation set with family-wise error correction (family-wise error, P < .05). Multiple regressions were used to analyze the associations between the abnormal fractional anisotropy (FA) in WM with disease duration, Pittsburgh Sleep Quality Index, insomnia severity index, self-rating anxiety scale, and the self-rating depression scale in primary insomnia. Characteristics for abnormal WM were also investigated in tract-level analyses. Results Primary insomnia patients had lower FA values mainly in the right anterior limb of the internal capsule, right posterior limb of the internal capsule, right anterior corona radiata, right superior corona radiata, right superior longitudinal fasciculus, body of the corpus callosum, and right thalamus (P < .05, family-wise error correction). The receiver operating characteristic areas for the seven regions were acceptable (range, 0.60-0.74; 60%-74%). Multiple regression models showed abnormal FA values in the thalamus and body corpus callosum were associated with the disease duration, self-rating depression scale, and Pittsburgh Sleep Quality Index scores. Tract-level analysis suggested that the reduced FA values might be related to greater radial diffusivity. Conclusion This study showed that WM tracts related to regulation of sleep and wakefulness, and limbic cognitive and sensorimotor regions, are disrupted in the right brain in patients with primary insomnia. The reduced integrity of these WM tracts may be because of loss of myelination. (©) RSNA, 2016.
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Affiliation(s)
- Shumei Li
- From the Department of Medical Imaging, Guangdong No. 2 Provincial People's Hospital, 1 Shiliugang Rd, Haizhu District, Guangzhou 510317, P. R. China (S.L., J.T., H.W., M.L., T.W., G.J.); Institute of Neuroscience and Medicine (INM-2), Forschungszentrum Jülich, Jülich, Germany (A.B.); Neurologic Department, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany (A.B.); Center for the Study of Applied Psychology, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, Guangzhou, P. R. China (R.H.); School of Psychology, South China Normal University, Guangzhou, P. R. China (R.H.); and Department of Magnetic Resonance Imaging, People's Hospital of YuXi City, YuXi, P. R. China (L.X.)
| | - Junzhang Tian
- From the Department of Medical Imaging, Guangdong No. 2 Provincial People's Hospital, 1 Shiliugang Rd, Haizhu District, Guangzhou 510317, P. R. China (S.L., J.T., H.W., M.L., T.W., G.J.); Institute of Neuroscience and Medicine (INM-2), Forschungszentrum Jülich, Jülich, Germany (A.B.); Neurologic Department, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany (A.B.); Center for the Study of Applied Psychology, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, Guangzhou, P. R. China (R.H.); School of Psychology, South China Normal University, Guangzhou, P. R. China (R.H.); and Department of Magnetic Resonance Imaging, People's Hospital of YuXi City, YuXi, P. R. China (L.X.)
| | - Andreas Bauer
- From the Department of Medical Imaging, Guangdong No. 2 Provincial People's Hospital, 1 Shiliugang Rd, Haizhu District, Guangzhou 510317, P. R. China (S.L., J.T., H.W., M.L., T.W., G.J.); Institute of Neuroscience and Medicine (INM-2), Forschungszentrum Jülich, Jülich, Germany (A.B.); Neurologic Department, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany (A.B.); Center for the Study of Applied Psychology, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, Guangzhou, P. R. China (R.H.); School of Psychology, South China Normal University, Guangzhou, P. R. China (R.H.); and Department of Magnetic Resonance Imaging, People's Hospital of YuXi City, YuXi, P. R. China (L.X.)
| | - Ruiwang Huang
- From the Department of Medical Imaging, Guangdong No. 2 Provincial People's Hospital, 1 Shiliugang Rd, Haizhu District, Guangzhou 510317, P. R. China (S.L., J.T., H.W., M.L., T.W., G.J.); Institute of Neuroscience and Medicine (INM-2), Forschungszentrum Jülich, Jülich, Germany (A.B.); Neurologic Department, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany (A.B.); Center for the Study of Applied Psychology, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, Guangzhou, P. R. China (R.H.); School of Psychology, South China Normal University, Guangzhou, P. R. China (R.H.); and Department of Magnetic Resonance Imaging, People's Hospital of YuXi City, YuXi, P. R. China (L.X.)
| | - Hua Wen
- From the Department of Medical Imaging, Guangdong No. 2 Provincial People's Hospital, 1 Shiliugang Rd, Haizhu District, Guangzhou 510317, P. R. China (S.L., J.T., H.W., M.L., T.W., G.J.); Institute of Neuroscience and Medicine (INM-2), Forschungszentrum Jülich, Jülich, Germany (A.B.); Neurologic Department, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany (A.B.); Center for the Study of Applied Psychology, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, Guangzhou, P. R. China (R.H.); School of Psychology, South China Normal University, Guangzhou, P. R. China (R.H.); and Department of Magnetic Resonance Imaging, People's Hospital of YuXi City, YuXi, P. R. China (L.X.)
| | - Meng Li
- From the Department of Medical Imaging, Guangdong No. 2 Provincial People's Hospital, 1 Shiliugang Rd, Haizhu District, Guangzhou 510317, P. R. China (S.L., J.T., H.W., M.L., T.W., G.J.); Institute of Neuroscience and Medicine (INM-2), Forschungszentrum Jülich, Jülich, Germany (A.B.); Neurologic Department, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany (A.B.); Center for the Study of Applied Psychology, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, Guangzhou, P. R. China (R.H.); School of Psychology, South China Normal University, Guangzhou, P. R. China (R.H.); and Department of Magnetic Resonance Imaging, People's Hospital of YuXi City, YuXi, P. R. China (L.X.)
| | - Tianyue Wang
- From the Department of Medical Imaging, Guangdong No. 2 Provincial People's Hospital, 1 Shiliugang Rd, Haizhu District, Guangzhou 510317, P. R. China (S.L., J.T., H.W., M.L., T.W., G.J.); Institute of Neuroscience and Medicine (INM-2), Forschungszentrum Jülich, Jülich, Germany (A.B.); Neurologic Department, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany (A.B.); Center for the Study of Applied Psychology, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, Guangzhou, P. R. China (R.H.); School of Psychology, South China Normal University, Guangzhou, P. R. China (R.H.); and Department of Magnetic Resonance Imaging, People's Hospital of YuXi City, YuXi, P. R. China (L.X.)
| | - Likun Xia
- From the Department of Medical Imaging, Guangdong No. 2 Provincial People's Hospital, 1 Shiliugang Rd, Haizhu District, Guangzhou 510317, P. R. China (S.L., J.T., H.W., M.L., T.W., G.J.); Institute of Neuroscience and Medicine (INM-2), Forschungszentrum Jülich, Jülich, Germany (A.B.); Neurologic Department, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany (A.B.); Center for the Study of Applied Psychology, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, Guangzhou, P. R. China (R.H.); School of Psychology, South China Normal University, Guangzhou, P. R. China (R.H.); and Department of Magnetic Resonance Imaging, People's Hospital of YuXi City, YuXi, P. R. China (L.X.)
| | - Guihua Jiang
- From the Department of Medical Imaging, Guangdong No. 2 Provincial People's Hospital, 1 Shiliugang Rd, Haizhu District, Guangzhou 510317, P. R. China (S.L., J.T., H.W., M.L., T.W., G.J.); Institute of Neuroscience and Medicine (INM-2), Forschungszentrum Jülich, Jülich, Germany (A.B.); Neurologic Department, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany (A.B.); Center for the Study of Applied Psychology, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, Guangzhou, P. R. China (R.H.); School of Psychology, South China Normal University, Guangzhou, P. R. China (R.H.); and Department of Magnetic Resonance Imaging, People's Hospital of YuXi City, YuXi, P. R. China (L.X.)
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Zhou ES, Partridge AH, Recklitis CJ. A pilot trial of brief group cognitive-behavioral treatment for insomnia in an adult cancer survivorship program. Psychooncology 2016; 26:843-848. [PMID: 26872123 DOI: 10.1002/pon.4096] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 12/17/2015] [Accepted: 01/18/2016] [Indexed: 12/14/2022]
Abstract
BACKGROUND Cognitive-behavioral therapy for insomnia (CBT-Insomnia) is effective, yet rarely available for cancer survivors. This is unfortunate because survivors are at elevated risk for insomnia, which is associated with significant health consequences in this already at-risk population. Barriers to delivering CBT-Insomnia in oncology settings include a lack of trained providers, distance to cancer centers, and treatment duration. PURPOSE To address insomnia treatment barriers, we adapted standard CBT-Insomnia treatment and evaluated a pilot group-based approach for feasibility and efficacy in an adult cancer survivorship program. METHODS Thirty-eight cancer survivors (mean age = 52.2 years) enrolled in our three-session program delivered over 1 month. They were primarily diagnosed with breast cancer (58.6%) and were an average of 6.0 years post-diagnosis and 3.6 years post-treatment. Participants completed sleep logs throughout the study and measures of sleep at baseline and week 4. RESULTS Participants reported experiencing insomnia symptoms an average of 2.4 years, with 89.7% indicating that the cancer experience had caused/exacerbated symptoms. Significant pre/post-intervention group improvements in sleep efficiency (77.3% to 88.5%), sleep quality, and insomnia symptoms were reported (all ps < .01). Less than 1 in 3 had discussed insomnia symptoms with their oncology providers in the prior year. CONCLUSIONS Pilot data indicate that a brief, group-based CBT-Insomnia intervention in a survivorship setting is both feasible and efficacious. There is a need to increase awareness about insomnia and its treatment among both cancer survivors and oncology providers. If validated in future studies, this novel approach can improve cancer survivors' access to much needed insomnia treatment. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Eric S Zhou
- Dana-Farber Cancer Institute, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Ann H Partridge
- Dana-Farber Cancer Institute, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
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New approach for analyzing self-reporting of insomnia symptoms reveals a high rate of comorbid insomnia across a wide spectrum of chronic diseases. Sleep Med 2015; 16:1332-1341. [DOI: 10.1016/j.sleep.2015.07.024] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Revised: 07/06/2015] [Accepted: 07/17/2015] [Indexed: 01/05/2023]
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35
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Ceklic T, Bastien CH. Information processing during NREM sleep and sleep quality in insomnia. Int J Psychophysiol 2015; 98:460-9. [PMID: 26506477 DOI: 10.1016/j.ijpsycho.2015.10.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2015] [Revised: 10/09/2015] [Accepted: 10/13/2015] [Indexed: 11/26/2022]
Abstract
Insomnia sufferers (INS) are cortically hyperaroused during sleep, which seems to translate into altered information processing during nighttime. While information processing, as measured by event-related potentials (ERPs), during wake appears to be associated with sleep quality of the preceding night, the existence of such an association during nighttime has never been investigated. This study aims to investigate nighttime information processing among good sleepers (GS) and INS while considering concomitant sleep quality. Following a multistep clinical evaluation, INS and GS participants underwent 4 consecutive nights of PSG recordings in the sleep laboratory. Thirty nine GS (mean age 34.56±9.02) and twenty nine INS (mean age 43.03±9.12) were included in the study. ERPs (N1, P2, N350) were recorded all night on Night 4 (oddball paradigm) during NREM sleep. Regardless of sleep quality, INS presented a larger N350 amplitude during SWS (p=0.042) while GS showed a larger N350 amplitude during late-night stage 2 sleep (p=0.004). Regardless of diagnosis, those who slept objectively well showed a smaller N350 amplitude (p=0.020) while those who slept subjectively well showed a smaller P2 (p<0.001) and N350 amplitude (p=0.006). Also, those who reported an objectively bad night as good showed smaller P2 (p< 0.001) and N350 (p=0.010) amplitudes. Information processing seems to be associated with concomitant subjective and objective sleep quality for both GS and INS. However, INS show an alteration in information processing during sleep, especially for inhibition processes, regardless of their sleep quality.
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Affiliation(s)
- Tijana Ceklic
- School of Psychology, Laval University, Quebec, Canada; Institut Universitaire en Santé Mentale de Quebec, Quebec, Canada
| | - Célyne H Bastien
- School of Psychology, Laval University, Quebec, Canada; Institut Universitaire en Santé Mentale de Quebec, Quebec, Canada.
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Palagini L, Drake CL, Gehrman P, Meerlo P, Riemann D. Early-life origin of adult insomnia: does prenatal–early-life stress play a role? Sleep Med 2015; 16:446-56. [DOI: 10.1016/j.sleep.2014.10.013] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Revised: 10/28/2014] [Accepted: 10/29/2014] [Indexed: 12/21/2022]
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Rogers LQ, Fogleman A, Trammell R, Hopkins-Price P, Spenner A, Vicari S, Rao K, Courneya KS, Hoelzer K, Robbs R, Verhulst S. Inflammation and psychosocial factors mediate exercise effects on sleep quality in breast cancer survivors: pilot randomized controlled trial. Psychooncology 2015; 24:302-10. [PMID: 24916951 PMCID: PMC4263679 DOI: 10.1002/pon.3594] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Revised: 05/12/2014] [Accepted: 05/16/2014] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To improve mechanistic understanding, this pilot randomized controlled trial examined mediators of an exercise intervention effects on sleep in breast cancer survivors (BCS). METHODS Forty-six postmenopausal BCS (≤Stage II, off primary treatment) were randomized to a 3-month exercise intervention or control group. Intervention included 160 min/week of moderate intensity aerobic walking, twice weekly resistance training (resistance bands), and six discussion groups (to improve adherence). Blinded assessments at baseline and post-intervention included sleep disturbance (PSQI and PROMIS®), objective sleep quality (accelerometer), serum cytokines, accelerometer physical activity, cardiorespiratory fitness, body composition, fatigue, and psychosocial factors. Mediation was tested using Freedman-Schatzkin difference-in-coefficients tests. RESULTS When compared with control, the intervention group demonstrated a significant increase in PSQI sleep duration (i.e., fewer hours of sleep/night) (d = 0.73, p = .03). Medium to large but non-significant standardized effect sizes were noted for PSQI daytime somnolence (d = -0.63, p = .05) and accelerometer latency (d = -0.49, p = .14). No statistically significant mediators were detected for PSQI sleep duration score or accelerometer latency. Daytime somnolence was mediated by tumor necrosis factor-alpha (mediated 23% of intervention effect, p < .05), interleukin (IL)-6:IL-10 (16%, p < .01), IL-8:IL-10 (26%, p < .01), and fatigue (38%, p < .05). Mediating or enhancing relationships for several of the sleep outcomes were noted for accelerometer physical activity, PROMIS® fatigue, exercise social support, and/or physical activity enjoyment. CONCLUSIONS Inflammation and psychosocial factors may mediate or enhance sleep response to our exercise intervention. Further study is warranted to confirm our results and translate our findings into more effective interventions aimed at improving sleep quality in BCS.
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Affiliation(s)
| | | | | | | | | | | | - Krishna Rao
- SIU School of Medicine, Springfield, IL, USA
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Ford ES, Cunningham TJ, Giles WH, Croft JB. Trends in insomnia and excessive daytime sleepiness among U.S. adults from 2002 to 2012. Sleep Med 2015; 16:372-8. [PMID: 25747141 DOI: 10.1016/j.sleep.2014.12.008] [Citation(s) in RCA: 211] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Revised: 12/30/2014] [Accepted: 12/31/2014] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Insomnia is a prevalent disorder in the United States and elsewhere. It has been associated with a range of somatic and psychiatric conditions, and adversely affects quality of life, productivity at work, and school performance. The objective of this study was to examine the trend in self-reported insomnia and excessive daytime sleepiness among US adults. METHODS We used data of participants aged ≥18 years from the National Health Interview Survey for the years 2002 (30,970 participants), 2007 (23,344 participants), and 2012 (34,509 participants). RESULTS The unadjusted prevalence of insomnia or trouble sleeping increased from 17.5% (representing 37.5 million adults) in 2002 to 19.2% (representing 46.2 million adults) in 2012 (relative increase: +8.0%) (P trend <0.001). The age-adjusted prevalence increased from 17.4% to 18.8%. Significant increases were present among participants aged 18-24, 25-34, 55-64, and 65-74 years, men, women, whites, Hispanics, participants with diabetes, and participants with joint pain. Large relative increases occurred among participants aged 18-24 years (+30.9%) and participants with diabetes (+27.0%). The age-adjusted percentage of participants who reported regularly having excessive daytime sleepiness increased from 9.8% to 12.7% (P trend <0.001). Significant increases were present in most demographic groups. The largest relative increase was among participants aged 25-34 years (+49%). Increases were also found among participants with hypertension, chronic obstructive pulmonary disease, asthma, and joint pain. CONCLUSIONS Given the deleterious effects of insomnia on health and performance, the increasing prevalence of insomnia and excessive daytime sleepiness among US adults is a potentially troubling development.
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Affiliation(s)
- Earl S Ford
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Timothy J Cunningham
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Wayne H Giles
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Janet B Croft
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Abstract
Quality sleep is critical for daily functions of human beings and thus the timing and duration of sleep are tightly controlled. However, rare genetic variants affecting sleep regulatory mechanisms can result in sleep phenotypes of extremely deviated sleep/wake onset time or duration. Using genetic analyses in families with multiple members expressing particular sleep phenotypes, these sleep-associated genetic variants can be identified. Deciphering the nature of these genetic variants using animal models or biochemical methods helps further our understanding of sleep processes. In this chapter, we describe the methods for studying genetics of human sleep behavioral phenotypes.
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Affiliation(s)
- Pei-Ken Hsu
- Department of Neurology, University of California, San Francisco, San Francisco, California, USA; Howard Hughes Medical Institute, University of California, San Francisco, San Francisco, California, USA
| | - Louis J Ptáček
- Department of Neurology, University of California, San Francisco, San Francisco, California, USA; Howard Hughes Medical Institute, University of California, San Francisco, San Francisco, California, USA.
| | - Ying-Hui Fu
- Department of Neurology, University of California, San Francisco, San Francisco, California, USA.
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40
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Functional connectivity changes between parietal and prefrontal cortices in primary insomnia patients: evidence from resting-state fMRI. Eur J Med Res 2014; 19:32. [PMID: 24915847 PMCID: PMC4062281 DOI: 10.1186/2047-783x-19-32] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Accepted: 05/15/2014] [Indexed: 12/05/2022] Open
Abstract
Background Primary insomnia can severely impair daytime function by disrupting attention and working memory and imposes a danger to self and others by increasing the risk of accidents. We speculated that the neurobiological changes impeding working memory in primary insomnia patients would be revealed by resting-state functional MRI (R-fMRI), which estimates the strength of cortical pathways by measuring local and regional correlations in blood oxygen level dependent (BOLD) signs independent of specific task demands. Methods We compared the R-fMRI activity patterns of 15 healthy controls to 15 primary insomnia patients (all 30 participants were right-handed) using a 3.0 T MRI scanner. The SPM8 and REST1.7 software packages were used for preprocessing and analysis. Activity was expressed relative to the superior parietal lobe (SPL, the seed region) to reveal differences in functional connectivity to other cortical regions implicated in spatial working memory. Result In healthy controls, bilateral SPL activity was associated with activity in the posterior cingulate gyrus, precuneus, ventromedial prefrontal cortex, and superior frontal gyrus, indicating functional connectivity between these regions. Strong functional connectivity between the SPL and bilateral pre-motor cortex, bilateral supplementary motor cortex, and left dorsolateral prefrontal cortex was observed in both the control group and the primary insomnia group. However, the strength of several other functional connectivity pathways to the SPL exhibited significant group differences. Compared to healthy controls, connectivity in the primary insomnia group was stronger between the bilateral SPL and the right ventral anterior cingulate cortex, left ventral posterior cingulate cortex, right splenium of the corpus callosum, right pars triangularis (right inferior frontal gyrus/Broca’s area), and right insular lobe, while connectivity was weaker between the SPL and right superior frontal gyrus (dorsolateral prefrontal cortex). Conclusion Primary insomnia appears to alter the functional connectivity between the parietal and frontal lobes, cortical structures critical for spatial and verbal working memory.
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Coulombe JA, Reid GJ. What do preschool-aged children do when they wake at night: toward an understanding of night-waking behaviors among community children. Behav Sleep Med 2014; 12:89-105. [PMID: 23480020 DOI: 10.1080/15402002.2013.764527] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Little is known about behaviors displayed by preschoolers during night-waking. Mothers (N = 203) of community preschoolers completed the Children's Night-waking Behavior Scale and measures of night-waking, co-sleeping, and daytime behavior. Approximately 1/2 of wakings involved calling out, getting out of bed, and requests for comfort; 1/4 involved activity, fear, or instrumental requests. Specific associations between night-waking behaviors, night-waking, and bedtime and daytime behaviors were observed; associations were not consistent across child gender and age. For example, comfort requests were associated with mothers' perceptions of sleep as problematic in 4- and 5-year-old children only (ρ = .42); activity requests were associated with hyperactivity for boys only (r = .36). Understanding night-waking requires consideration of factors beyond parenting, such as children's behavior, age, and gender.
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Affiliation(s)
- J Aimée Coulombe
- a Department of Psychology , The University of Western Ontario , London , Ontario , Canada
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Singh JK, Learman LA, Nakagawa S, Gregorich SE, Kuppermann M. Sleep problems among women with noncancerous gynecologic conditions. J Psychosom Obstet Gynaecol 2014; 35:29-35. [PMID: 24393058 DOI: 10.3109/0167482x.2013.868880] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To estimate the prevalence of and identify factors associated with poor sleep quality and short sleep duration among women with noncancerous gynecologic conditions. STUDY DESIGN We conducted a cross-sectional analysis of 838 pre-menopausal women aged 31-54 who enrolled in a study of pelvic problems, hysterectomy and intervention alternatives in 2003/2004. Primary outcomes were poor sleep quality and short sleep duration (six or less hours on average) in the four weeks preceding the interview; hypothesized correlates included sociodemographic characteristics, pelvic problem impact, measured by the Pelvic Problem Impact Questionnaire (PPIQ), and depression, measured by the Patient Health Questionnaire (PHQ). RESULTS One-third (33.7%) of the participants reported having poor sleep quality and nearly half (46.8%) reported short sleep duration. In multivariable models, women with major depressive disorder were more likely than those who were not depressed to experience poor sleep quality (adjusted odds ratio (aOR) 4.15, 95% confidence interval (CI) 2.36-7.28, p < 0.001). Women with higher PPIQ scores also were more likely to experience poor sleep quality (aOR 1.59, 95% CI 1.27-1.98, p < 0.001) and short sleep duration (aOR 1.37, 95% CI 1.11-1.69, p < 0.003). Finally, women who self-identified as African-American (aOR 2.81, 95% CI 1.83-4.32, p < 0.001) or Asian/Pacific Islander (aOR 2.32, 95% CI 1.32-4.09, p < 0.003) were more likely than White women to have short sleep duration. CONCLUSIONS Sleep problems are prevalent among women with noncancerous gynecologic conditions, and are associated with depression and high pelvic problem impact. Providers should be proactive in inquiring about and offering solutions for sleep difficulties experienced by their patients.
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Affiliation(s)
- Jaspreet K Singh
- Departments of Obstetrics, Gynecology & Reproductive Sciences, University of California , San Francisco, CA , USA
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Matthews EE, Arnedt JT, McCarthy MS, Cuddihy LJ, Aloia MS. Adherence to cognitive behavioral therapy for insomnia: a systematic review. Sleep Med Rev 2013; 17:453-64. [PMID: 23602124 PMCID: PMC3720832 DOI: 10.1016/j.smrv.2013.01.001] [Citation(s) in RCA: 112] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Revised: 01/02/2013] [Accepted: 01/02/2013] [Indexed: 10/27/2022]
Abstract
Chronic insomnia is a significant public health problem worldwide, and insomnia has considerable personal and social costs associated with serious health conditions, greater healthcare utilization, work absenteeism, and motor-vehicle accidents. Cognitive behavioral therapy for insomnia (CBTI) is an efficacious treatment, yet attrition and suboptimal adherence may diminish its impact. Despite the increasing use of CBTI, surprisingly little attention has been devoted to understanding the role of adherence. This review describes a comprehensive literature search of adherence to CBTI. The search revealed 15 studies that evaluated adherence to CBTI in adults using valid and reliable measures of sleep, and measure of adherence other than study withdrawals. The primary purposes of this review were to 1) synthesize current study characteristics, methodology, adherence rates, contributing factors, and impact on outcomes, 2) discuss measurement issues, and 3) identify future practice and research directions that may lead to improved outcomes. Strong patterns and inconsistencies were identified among the studies, which complicate an evaluation of the role of adherence as a factor and outcome of CBTI success. The importance of standardized adherence and outcome measures is discussed. In light of the importance of adherence to behavior change, this systematic review may better inform future intervention efforts.
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Affiliation(s)
- Ellyn E Matthews
- University of Colorado Denver, College of Nursing, Aurora, CO 80045, USA.
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Fung CH, Jouldjian S, Kierlin L. Depictions of insomniacs' behaviors and thoughts in music lyrics. SLEEP DISORDERS 2013; 2013:106492. [PMID: 23471424 PMCID: PMC3581261 DOI: 10.1155/2013/106492] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/24/2012] [Accepted: 12/21/2012] [Indexed: 11/17/2022]
Abstract
Study Objectives. Studies have found that depictions of unhealthy behaviors (e.g., illicit substance use, violence) are common in popular music lyrics; however, we are unaware of any studies that have specifically analyzed the content of music lyrics for unhealthy sleep-related behaviors. We sought to determine whether behaviors known to perpetuate insomnia symptoms are commonly depicted in the lyrics of popular music. Methods. We searched three online lyrics sites for lyrics with the word "insomnia" in the title and performed content analysis of each of the lyrics. Lyrics were analyzed for the presence/absence of the following perpetuating factors: extending sleep opportunity, using counter fatigue measures, self-medicating, and engaging in rituals or anti-stimulus control behaviors. Results. We analyzed 83 music lyrics. 47% described one or more perpetuating factor. 30% described individual(s) engaging in rituals or antistimulus control strategies, 24% described self-medicating, 7% described engaging in counter fatigue measures, and 2% described extending sleep opportunity (e.g., napping during daytime). Conclusion. Maladaptive strategies known to perpetuate insomnia symptoms are common in popular music. Our results suggest that listeners of these sleep-related songs are frequently exposed to lyrics that depict maladaptive coping mechanisms. Additional studies are needed to examine the direct effects of exposing individuals to music lyrics with this content.
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Affiliation(s)
- Constance H. Fung
- Geriatric Research Education and Clinical Center (GRECC), Veterans Administration Greater Los Angeles Healthcare System, North Hills, CA 91343, USA
- David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA
| | - Stella Jouldjian
- Geriatric Research Education and Clinical Center (GRECC), Veterans Administration Greater Los Angeles Healthcare System, North Hills, CA 91343, USA
| | - Lara Kierlin
- Oregon Sleep Associates, Portland, OR 97210, USA
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