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Türkarslan KK, Canel Çınarbaş D. Insomnia Severity Predicts Psychiatric Symptoms: A Cross-Sectional Study Investigating the Partial Mediations of Worry and Rumination. Psychiatry 2024; 87:179-193. [PMID: 38758524 DOI: 10.1080/00332747.2024.2347100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
OBJECTIVE Insomnia as a disorder on its own or as a symptom of other mental disorders can lead to significant distress and lower quality of life. By exacerbating negative affect and emotion dysregulation, poor sleep and insomnia can contribute to the initiation and maintenance of mental disorders. The aim of this cross-sectional study was to investigate the relationship between insomnia severity and overall psychiatric symptoms (anxiety, depression, obsessive-compulsive symptoms, somatization, phobic anxiety, hostility, interpersonal sensitivity, paranoid ideation, and psychoticism), and the mediational roles of worry and rumination in this relationship. METHOD The data was collected from a community sample of 1444 participants (females 69.39%, Mage = 27.95, SD = 9.37) who completed self-report measures of insomnia severity, worry, rumination, and psychiatric symptoms. The mediational roles of worry and rumination were tested with mediation analysis using the PROCESS Macro. RESULTS It was found that insomnia severity (β = 0.20, p < .001) significantly predicted psychiatric symptoms directly and via worry and rumination (β = 0.33, p < .001), meaning that worry and rumination partially mediated the relationship between insomnia severity and psychiatric symptoms. The findings were similar after controlling for smoking status, daily screen time, coffee consumption in the evening, weekly exercise frequency, and pre-sleep screen time. CONCLUSIONS Interventions targeting the reduction of insomnia severity and maladaptive emotion regulation strategies (e.g., worry and rumination), as well as the enhancement of adaptive emotion regulation strategies (e.g., positive refocusing and mindfulness), may alleviate the adverse effects of insomnia on psychiatric symptoms.
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2
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Goodhines PA, Rathod K. Substance use and sleep health in young adults: Implications for integrated treatment and harm reduction. Sleep Med Rev 2023; 70:101811. [PMID: 37423096 DOI: 10.1016/j.smrv.2023.101811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 06/27/2023] [Indexed: 07/11/2023]
Abstract
In their systematic review and meta-analysis, Meneo and colleagues document distinct substance-sleep effects reported by young adults (ages 18-30) across multidimensional sleep health and different substances used in the naturalistic environment, including alarming rates of self-medication for sleep aid. Key innovations of Meneo et al.'s review include (a) a multidimensional approach to defining sleep health and (b) robust inclusion of various substances commonly used in young adults. Although future research will be essential to clarifying transdiagnostic risk mechanisms, interplay of co-used substances, and the role of expectancies in risk processes, the developing literature reviewed herein may inform much-needed clinical recommendations. This work by Meneo et al should prompt an emphasis on approaching young adult substance use and self-medication through a harm reduction lens, highlighting recommendations for integrated behavioral sleep treatment tailored to stage of change using motivational interviewing.
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Ferreira MF, Bos SC, Macedo AF. The impact of physical activity on objective sleep of people with insomnia. Psychiatry Res 2023; 320:115019. [PMID: 36577233 DOI: 10.1016/j.psychres.2022.115019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 12/14/2022] [Accepted: 12/18/2022] [Indexed: 12/24/2022]
Abstract
The aim of our study was to investigate if physical activity has a beneficial impact on insomnia. A systematic literature review was conducted in PubMed database using the terms "Physical activity" and "Insomnia" and 591 records were retrieved. The preferred reporting items for systematic reviews and meta-analyses guidelines were followed and fifteen articles were considered eligible for further analysis. Participants were mainly female, between 40 and 60 years; design studies were variable and most studies involved long-term interventions; insomnia definition was mainly based on diagnostic criteria or considered a specific cut-off point of well-known insomnia questionnaires; sleep was mostly assessed with polysomnography (PSG) or actigraphy; physical activity interventions included different methodologies (predominantly treadmill exercise). A beneficial effect of physical activity on insomnia was observed in most studies when sleep was evaluated with PSG or actigraphy. Sleep efficiency was the objective sleep parameter that mainly provided statistically significant results, as expected, followed by sleep onset latency, wake after sleep onset and, less frequently, total sleep time. Using objective methods to assess sleep in insomnia might be useful to support subjective insomnia complaints and to evaluate the efficacy of physical activity interventions in ameliorating sleep of people with insomnia.
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Affiliation(s)
| | - Sandra Carvalho Bos
- Institute of Medical Psychology, Faculty of Medicine, University of Coimbra, Portugal.
| | - António Ferreira Macedo
- Institute of Medical Psychology, Faculty of Medicine, University of Coimbra, Portugal; Department of Psychiatry, Coimbra Hospital and University Centre, Portugal
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4
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Hu CJ, Chen YJ, Hong RM. Insomnia among female flight attendants: Related factors and its association with mental health. Work 2023; 76:1455-1463. [PMID: 37393471 DOI: 10.3233/wor-220431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/03/2023] Open
Abstract
BACKGROUND Sleep and mental health are very important in the aviation industry. Reports show that gender is one of the risk factors of insomnia, and most Asian flight attendants are female. Therefore, it is necessary to understand insomnia, and the correction to mental health among female flight attendants. OBJECTIVE To investigate the prevalence of insomnia in female flight attendants and its association with mental health. METHODS We used a cross-sectional design. We recruited 412 female flight attendants with more than 3 months of working experience. We collected the socio-demographic and work-related data, measured insomnia and mental health by the Athens Insomnia and Brief Symptom Rating Scales. Descriptive statistics, single-factor analysis of variance, Pearson's correlation analysis, and structural equation modeling were performed to analyze the relationships. RESULTS There are 45.4% of female flight attendants having insomnia, and 24.8% had suspicious insomnia. The most considerable and serious insomnia problem was falling asleep (15.3%, 4.9%). Factors related to insomnia include smoking, drinking, family load (e.g., housekeeping and caring for family), economic stress and late-night/early morning workdays during last month. Also, insomnia had a direct association with mental health (T = 17.11, p < 0.001). CONCLUSION We found that insomnia is negatively correlated with the above factors and mental health. We recommend that airline industries can run their sleep-education programs and provide relevant mental-health-promotion programs for flight attendants.
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Affiliation(s)
- Chia Jung Hu
- Department of Nursing, Da-Yeh University, Changhua, Taiwan
| | - Yen Ju Chen
- Department of Nursing, Da-Yeh University, Changhua, Taiwan
| | - Rei Mei Hong
- Chang Gung University of Science and Technology, Chiayi Campus, Chiayi, Taiwan
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5
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Yamamoto M, Lim CT, Huang H, Spottswood M, Huang H. Insomnia in primary care: Considerations for screening, assessment, and management. THE JOURNAL OF MEDICINE ACCESS 2023; 7:27550834231156727. [PMID: 36938324 PMCID: PMC10021100 DOI: 10.1177/27550834231156727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 01/25/2023] [Indexed: 03/17/2023]
Abstract
Insomnia, including insomnia disorder, is a common but often overlooked complaint in primary care settings. It is a risk factor for various medical and psychiatric diagnoses and is associated with substantial health care costs. While cognitive behavioral therapy for insomnia (CBT-I) is the first-line treatment for insomnia disorder, access to CBT-I is limited. This article provides a pragmatic approach to screening, assessment, and treatment of insomnia in the primary care setting, promoting a population health approach. The authors review the role of CBT-I, treatment of comorbid conditions, and pharmacologic recommendations in working with primary care patients with insomnia. In addition, the authors highlight the potential utility of technology in improving access to insomnia care.
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Affiliation(s)
- Mari Yamamoto
- Department of Family Medicine,
University of Washington School of Medicine, Seattle, WA, USA
- Mari Yamamoto, Department of Family
Medicine, University of Washington School of Medicine, Seattle, WA 98125, USA.
| | - Christopher T Lim
- Department of Psychiatry, Boston
Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - Heather Huang
- Departments of Internal Medicine and
Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison,
WI, USA
| | - Margaret Spottswood
- Department of Psychiatry, University of
Vermont College of Medicine, Burlington, VT, USA
- Community Health Centers of Burlington,
Burlington, VT, USA
| | - Hsiang Huang
- Department of Psychiatry, Cambridge
Health Alliance, Cambridge, MA, USA
- Harvard Medical School, Boston, MA,
USA
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6
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Sheppard N, Hogan L. Prevalence of insomnia and poor sleep quality in the prison population: A systematic review. J Sleep Res 2022; 31:e13677. [PMID: 35790475 PMCID: PMC9787802 DOI: 10.1111/jsr.13677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 05/30/2022] [Accepted: 06/07/2022] [Indexed: 12/30/2022]
Abstract
Insomnia is a public health concern with several associated negative health-related outcomes. Risk factors for insomnia place the prison population at an increased risk of inadequate sleep. This paper systematically reviewed the literature reporting on the prevalence of insomnia and poor sleep quality in the prison population. Following a comprehensive database search and screening process, 12 studies were eligible for inclusion in this review. Six studies provided prevalence rates for insomnia and nine for poor sleep quality. Varied prevalence rates were found for insomnia (i.e. 26.2%-72.5%) and poor sleep quality (i.e. 42.8%-88.2%). Evaluation of the prevalence rates revealed varied measurement of sleep quality, inconsistent parameters of standardised measures, and methodological heterogeneity. Other considerations were given to geographical differences, the use of self-report data, gender difference, environmental factors and comorbidities of insomnia. The review highlighted an increase in the quantity of studies and some improved quality; although the findings were highly variable, in the main, inadequate sleep amongst prisoners was higher than the general population. Limitations of the review and implications for further research are discussed.
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Affiliation(s)
- Nia Sheppard
- North Wales Clinical Psychology ProgrammeBangor UniversityBangorUK,Betsi Cadwaladr University Health BoardBangorUK
| | - Lee Hogan
- North Wales Clinical Psychology ProgrammeBangor UniversityBangorUK,Betsi Cadwaladr University Health BoardBangorUK
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7
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Baek SU, Yoon JH, Won JU. Association between Workers' Anxiety over Technological Automation and Sleep Disturbance: Results from a Nationally Representative Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10051. [PMID: 36011684 PMCID: PMC9408459 DOI: 10.3390/ijerph191610051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/06/2022] [Accepted: 08/13/2022] [Indexed: 06/15/2023]
Abstract
Despite the positive aspects of recent technological innovations, fears are mounting among workers that machines will inevitably replace most human jobs in the future. This study is the first to explore the association between individual-level automation anxiety and insomnia among workers. We scored the worker's anxiety over technological automation with five questions. The total sum of scores for participants was categorized in quartiles (Q1-Q4). Logistic regression was employed to estimate odds ratios (ORs) and confidence intervals (CIs). The highest scoring group (Q4) had the highest OR for sleep disturbance (OR [95% CI]:1.40 [1.27-1.55]) compared to the lowest scoring group (Q1). ORs of the highest scoring group (Q4) were strongest for the young (OR [95% CI]:1.96 [1.52-2.53]), followed by the middle-aged (OR [95% CI]:1.40 [1.20-1.64]), and old age groups (OR [95% CI]:1.29 [1.10-1.51]). In addition, a 1-point increase in the automation anxiety score had the strongest association with sleep disturbance in the young (OR [95% CI]:1.07 [1.05-1.10]), followed by the middle-aged (OR [95% CI]:1.03 [1.02-1.04]), and old age groups (OR [95% CI]:1.02 [1.01-1.04]). Our study suggests that policies such as worker retraining are needed to alleviate workers' undue anxiety.
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Affiliation(s)
- Seong-Uk Baek
- Department of Occupational and Environmental Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul 3722, Korea
- Graduate School, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Jin-Ha Yoon
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul 3722, Korea
- Graduate School of Public Health, Yonsei University College of Medicine, Seoul 03722, Korea
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Jong-Uk Won
- Department of Occupational and Environmental Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul 3722, Korea
- Graduate School of Public Health, Yonsei University College of Medicine, Seoul 03722, Korea
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8
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Zhaoyang H, Feng C, Mei F, Jingjing L, Jiyang P. Negative perfectionism and sleep quality in Chinese international students under COVID-19 epidemic: A moderated mediation. Front Psychol 2022; 13:937816. [PMID: 35978773 PMCID: PMC9377220 DOI: 10.3389/fpsyg.2022.937816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 07/14/2022] [Indexed: 11/25/2022] Open
Abstract
Objective This study used a moderated mediation model to test the mediating effect of anxiety on the relationship between negative perfectionism and sleep quality and the moderating effect of COVID-19 epidemic risk perception during the COVID-19 pandemic in Chinese international students. Materials and methods A sample of 239 Chinese international students from the south of China, was surveyed with the Negative and Positive Perfectionism Scale, the Pittsburgh Sleep Quality Index, the General Anxiety Disorder Scale, and the COVID-19 Epidemic Risk Perception Inventory. Version 23.0 of SPSS and version 3.4 of PROCESS were used to perform the correlation analyses, mediation analysis, and moderated mediation analysis. Results (1) Negative perfectionism was significantly correlated with anxiety (r = 0.371, p < 0.01) and poor sleep quality (r = 0.291, p < 0.01). Anxiety was significantly correlated with poor sleep quality (r = 0.594, p < 0.01). (2) The mediating effect test showed that anxiety had a mediating effect between negative perfectionism and poor sleep quality (β = 0.157, p < 0.01). (3) Epidemic risk perception moderated the mediating effect of anxiety between negative perfectionism and poor sleep quality (β = 0.070, p < 0.01). Conclusion Negative perfectionism affected sleep quality indirectly through anxiety. In particular, COVID-19 epidemic risk perception moderated the relationship between anxiety and sleep quality, such that the association was stronger when the COVID-19 epidemic risk perception was high. These results provide a more comprehensive understanding of the negative link between negative perfectionism and poor sleep quality.
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Affiliation(s)
- Huang Zhaoyang
- Department of Psychiatry, The First Affiliated Hospital of Jinan University, Guangzhou, China
- School of Management, Jinan University, Guangzhou, China
| | - Chen Feng
- Department of Psychiatry, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Fan Mei
- Department of Psychiatry, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Lin Jingjing
- Department of Psychiatry, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Pan Jiyang
- Department of Psychiatry, The First Affiliated Hospital of Jinan University, Guangzhou, China
- *Correspondence: Pan Jiyang,
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Mental Health Conditions According to Stress and Sleep Disorders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137957. [PMID: 35805615 PMCID: PMC9265846 DOI: 10.3390/ijerph19137957] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 06/25/2022] [Accepted: 06/27/2022] [Indexed: 02/06/2023]
Abstract
The purpose of this study was to compare associations between stress and sleep disorders (insomnia, hypersomnia, and sleep apnea), identify potential modifying effects, and compare associations between stress and types of sleep disorders with selected mental health conditions. Analyses were based on 21,027 employees aged 18–64 years in 2020 who were insured by the Deseret Mutual Benefit Administrators (DMBA). The risk of stress (2.3%) was significantly greater in women, singles, and those with dependent children. The risk of a sleep disorder was 12.1% (2.1% for insomnia, 1.0% for hypersomnia, and 10.1% for sleep apnea). The risk of stress was significantly greater for those with a sleep disorder (136% overall, 179% for insomnia, and 102% for sleep apnea after adjusting for age, sex, marital status, dependent children, and sleep disorders). The risk of stress among those with sleep apnea was significantly greater for singles than for married individuals. Approximately 9.5% had anxiety, 8.5% had depression, 2.0% had ADHD, 0.6% had bipolar disorder, 0.4% had OCD, and 0.1% had schizophrenia. Each of these mental health conditions was significantly positively associated with stress and sleep disorders. Bipolar disorder and schizophrenia were more strongly associated with stress and sleep disorders than were the other mental health conditions. Insomnia was more strongly associated with anxiety, bipolar disorder, OCD, and schizophrenia than was sleep apnea.
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10
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Silva BM, Carvalho Bos S, Queirós AJV, Macedo AF. Psychological factors and healthy sleep in a Portuguese sample of employees with regular working hours. BIOL RHYTHM RES 2022. [DOI: 10.1080/09291016.2022.2045058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- Beatriz Marques Silva
- Institute of Medical Psychology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Sandra Carvalho Bos
- Institute of Medical Psychology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | | | - António Ferreira Macedo
- Institute of Medical Psychology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Department of Psychiatry, Coimbra Hospital and University Centre, Coimbra, Portugal
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11
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Lay awake with a racing mind: The associations between sexual objectification, insomnia, and affective symptoms. J Affect Disord 2022; 299:359-366. [PMID: 34915082 DOI: 10.1016/j.jad.2021.12.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 11/09/2021] [Accepted: 12/12/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Sexual objectification is a form of interpersonal maltreatment that women may experience in daily life. Research has focused on testing how it leads to various psychological distresses. However, little research has examined its influences on women's sleep quality, the underlying psychological mechanisms, and the potential implications for affective symptoms. We addressed this research gap by testing whether sexual objectification predicted perceived stress and insomnia, thereby predicting affective symptoms (i.e., depression and anxiety). We further examined whether sex-is-power beliefs moderated these associations. METHODS Participants completed validated measures of sex-is-power beliefs, sexual objectification, perceived stress, insomnia, depression, and anxiety. We conducted regression analyses, structural equation modeling, and bootstrapping analyses to test the associations between these psychological constructs. RESULTS As predicted, the results showed that sexual objectification was positively associated with perceived stress, insomnia, and affective symptoms. Moreover, perceived stress and insomnia serially mediated the association between sexual objectification and affective symptoms. Furthermore, sex-is-power beliefs moderated the serial mediation effect, such that the effect was only observed among participants with weak sex-is-power beliefs. CONCLUSIONS These findings advanced current theories and knowledge of sexual objectification by demonstrating that sexual objectification is associated with perceived stress and insomnia, thereby predicting affective symptoms. The findings also highlighted the role of beliefs in weakening the negative consequences of sexual objectification.
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12
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Stricker J, Kröger L, Küskens A, Gieselmann A, Pietrowsky R. No perfect sleep! A systematic review of the link between multidimensional perfectionism and sleep disturbance. J Sleep Res 2022; 31:e13548. [DOI: 10.1111/jsr.13548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 12/23/2021] [Accepted: 12/26/2021] [Indexed: 01/23/2023]
Affiliation(s)
- Johannes Stricker
- Department of Experimental Psychology Heinrich Heine University Düsseldorf Düsseldorf Germany
| | - Lasse Kröger
- Department of Psychology University of Trier Trier Germany
| | - Anna Küskens
- Department of Experimental Psychology Heinrich Heine University Düsseldorf Düsseldorf Germany
| | - Annika Gieselmann
- Department of Experimental Psychology Heinrich Heine University Düsseldorf Düsseldorf Germany
| | - Reinhard Pietrowsky
- Department of Experimental Psychology Heinrich Heine University Düsseldorf Düsseldorf Germany
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13
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Cai H, Zhao YJ, Xing X, Tian T, Qian W, Liang S, Wang Z, Cheung T, Su Z, Tang YL, Ng CH, Sha S, Xiang YT. Network Analysis of Comorbid Anxiety and Insomnia Among Clinicians with Depressive Symptoms During the Late Stage of the COVID-19 Pandemic: A Cross-Sectional Study. Nat Sci Sleep 2022; 14:1351-1362. [PMID: 35959360 PMCID: PMC9359521 DOI: 10.2147/nss.s367974] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 07/18/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND A high proportion of clinicians experienced common anxiety, insomnia and depression during the COVID-19 pandemic. This study examined the item-level association of comorbid anxiety and insomnia symptoms among clinicians who suffered from depressive symptoms during the late stage of the COVID-19 pandemic using network analysis (NA). METHODS Clinicians with depressive symptoms (with a Patients Health Questionnaire (PHQ-9) total score of 5 and above) were included in this study. Anxiety and insomnia symptoms were measured using the Generalized Anxiety Disorder Scale - 7-item (GAD-7) and Insomnia Severity Index (ISI), respectively. Network analysis was conducted to investigate the network structure, central symptoms, bridge symptoms, and network stability of these disturbances. Expected influence (EI) was used to measure the centrality of index. RESULTS Altogether, 1729 clinicians were included in this study. The mean age was 37.1 [standard deviation (SD)=8.04 years], while the mean PHQ-9 total score was 8.42 (SD=3.33), mean GAD-7 total score was 6.45 (SD=3.13) and mean ISI total score was 8.23 (SD=5.26). Of these clinicians, the prevalence of comorbid anxiety symptoms (GAD-7≥5) was 76.8% (95% CI 74.82-78.80%), while the prevalence of comorbid insomnia symptoms (ISI≥8) was 43.8% (95% CI: 41.50-46.18%). NA revealed that nodes ISI7 ("Interference with daytime functioning") (EI=1.18), ISI4 ("Sleep dissatisfaction") (EI=1.08) and ISI5 ("Noticeability of sleep problem by others") (EI=1.07) were the most central (influential) symptoms in the network model of comorbid anxiety and insomnia symptoms in clinicians. Bridge symptoms included nodes PHQ3 ("Sleep") (bridge EI=0.55) and PHQ4 ("Fatigue") (bridge EI=0.49). Gender did not significantly influence the network structure, but "having the experience of caring for COVID-19 patients" significantly influenced the network structure. CONCLUSION Central symptoms and key bridge symptoms identified in this NA should be targeted in the treatment and preventive measures for clinicians suffering from comorbid anxiety, insomnia and depressive symptoms during the late stage of the COVID-19 pandemic.
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Affiliation(s)
- Hong Cai
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao Special Administrative Region, People's Republic of China.,Centre for Cognitive and Brain Sciences, University of Macau, Macao Special Administrative Region, People's Republic of China.,Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao Special Administrative Region, People's Republic of China
| | - Yan-Jie Zhao
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao Special Administrative Region, People's Republic of China.,Centre for Cognitive and Brain Sciences, University of Macau, Macao Special Administrative Region, People's Republic of China.,Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao Special Administrative Region, People's Republic of China
| | - Xiaomeng Xing
- The National Clinical Research Center for Mental Disorder & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, People's Republic of China
| | - Tengfei Tian
- The National Clinical Research Center for Mental Disorder & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, People's Republic of China
| | - Wang Qian
- The National Clinical Research Center for Mental Disorder & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, People's Republic of China
| | - Sixiang Liang
- The National Clinical Research Center for Mental Disorder & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, People's Republic of China
| | - Zhe Wang
- The National Clinical Research Center for Mental Disorder & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, People's Republic of China
| | - Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Hong Kong Special Administrative Region, People's Republic of China
| | - Zhaohui Su
- School of Public Health, Southeast University, Nanjing, China, Nanjing, People's Republic of China
| | - Yi-Lang Tang
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA.,Atlanta VA Medical Center, Decatur, GA, USA
| | - Chee H Ng
- Department of Psychiatry, The Melbourne Clinic and St Vincent's Hospital, University of Melbourne, Richmond, Victoria, Australia
| | - Sha Sha
- The National Clinical Research Center for Mental Disorder & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, People's Republic of China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao Special Administrative Region, People's Republic of China.,Centre for Cognitive and Brain Sciences, University of Macau, Macao Special Administrative Region, People's Republic of China.,Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao Special Administrative Region, People's Republic of China
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14
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Musetti A, Gori A, Alessandra A, Topino E, Terrone G, Plazzi G, Cacioppo M, Franceschini C. The Interplay Between Problematic Online Pornography Use, Psychological Stress, Emotion Dysregulation and Insomnia Symptoms During the COVID-19 Pandemic: A Mediation Analysis. Nat Sci Sleep 2022; 14:83-92. [PMID: 35082545 PMCID: PMC8786338 DOI: 10.2147/nss.s348242] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 01/13/2022] [Indexed: 12/16/2022] Open
Abstract
PURPOSE Although a link between problematic online pornographic use (POPU) and insomnia symptoms has been established, psychological and psychopathological mechanisms underlying this relationship are still not clear. Psychological stress and emotion dysregulation have been pointed out as relevant in the development and maintenance of insomnia. This study aims to explore the associations between POPU, psychological stress, emotion dysregulation and insomnia symptoms and to understand the mediating role of psychological stress and emotion dysregulation in the relationship between POPU and insomnia symptoms. PARTICIPANTS AND METHODS A sample of 776 Italian adults aged 19-48 years (51.4% female; M age = 28.49; SD = 7.33) completed questionnaires regarding demographics, COVID-19-related variables, POPU, psychological stress, emotion dysregulation, and insomnia symptoms. RESULTS After controlling for demographic covariates and COVID-19-related variables, multiple mediation model showed that higher psychological stress and emotion dysregulation fully mediated the link between POPU and insomnia. CONCLUSION The findings underscore the significance of the negative consequences of POPU and underline the importance of working on this and its effects on psychological stress and emotion dysregulation to limit insomnia.
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Affiliation(s)
- Alessandro Musetti
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Parma, Italy
| | - Alessio Gori
- Department of Health Sciences, University of Florence, Florence, Italy
| | | | - Eleonora Topino
- Department of Human Sciences, Lumsa University of Rome, Rome, Italy
| | - Grazia Terrone
- Department of History, Cultural Heritage, Education and Society, University of Rome Tor Vergata, Rome, Italy
| | - Giuseppe Plazzi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.,IRCCS Institute of Neurological Sciences of Bologna (ISNB), Bologna, Italy
| | - Marco Cacioppo
- Department of Human Sciences, Lumsa University of Rome, Rome, Italy
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15
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Predictors of diagnostically defined insomnia in child and adolescent community samples: a literature review. Sleep Med 2021; 87:241-249. [PMID: 34649120 DOI: 10.1016/j.sleep.2021.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 09/01/2021] [Accepted: 09/05/2021] [Indexed: 12/21/2022]
Abstract
Diagnostically defined insomnia is prevalent, persistent, and associated with a range of negative outcomes in childhood and adolescence. To inform prevention and treatment, we need to identify relevant predictors that can be addressed in such intervention efforts. Therefore, a systematic search for longitudinal studies involving child and adolescent samples (ages 4 to 19) examining predictors of diagnostically defined insomnia adjusted for previous insomnia was conducted. The search identified 6419 studies, resulting in six included papers involving five samples (n = 9949) conducted in five different countries (the US, New Zealand, Norway, China, and Japan). Few longitudinal studies investigated the predictors of diagnostically defined insomnia in children and adolescents, and insomnia is rarely defined according to diagnostic manuals. The results suggested that poor mental health (most notably depression) and female sex may be involved in the etiology of diagnostically defined insomnia. Stress might be the most modifiable factor identified. However, the diversity of the predictors studied in previous reports combined with the lack of replication prevent any firm conclusions from being drawn. This review serves as a summary of the best available evidence.
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16
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Tucker RP, Cramer RJ, Langhinrichsen-Rohling J, Rodriguez-Cue R, Rasmussen S, Oakey-Frost N, Franks CM, Cunningham CCA. Insomnia and suicide risk: a multi-study replication and extension among military and high-risk college student samples. Sleep Med 2021; 85:94-104. [PMID: 34298228 DOI: 10.1016/j.sleep.2021.06.032] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 05/31/2021] [Accepted: 06/21/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE/BACKGROUND A clear link between insomnia concerns and suicidal ideation has been shown in a variety of populations. These investigations failed to use a theoretical lens in understanding this relationship. Research within the veteran population has demonstrated that feelings of thwarted belongingness (TB), but not perceived burdensomeness (PB), mediate the insomnia and suicidal ideation relationship. Using two high risk samples, the present investigation replicated and extended this line of inquiry to include interpersonal hopelessness about TB, a key component of the Interpersonal Psychological Theory of Suicide. METHODS/RESULTS/CONCLUSIONS Using medical record review and survey data, study 1 replicated the finding that TB is a stronger explanatory factor of the insomnia to suicidal ideation/suicide risk relationship in a sample of N = 200 treatment-seeking active-duty personnel. Study 2 found that insomnia symptoms had an indirect effect on suicidal ideation through TB and PB but not interpersonal hopelessness in a sample of N = 151 college students with a history of suicidal thoughts and/or behaviors. TB was the only mediator of the insomnia-suicide attempt likelihood link and insomnia to clinically significant suicide risk screening status. Limitations include cross-sectional design of both studies and the lack of formal diagnoses of insomnia. Implications and future research directions are discussed.
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Affiliation(s)
| | | | | | | | | | | | - Capt Michael Franks
- US Public Health Service, Naval Medical Center Psychology Training Programs, Navy Medicine Readiness and Training Command Portsmouth, Portsmouth, VA, 23708, USA
| | - Capt Craig A Cunningham
- Nursing Research and Consultation Services, Navy Medicine Readiness and Training Command Portsmouth, Portsmouth, VA, 23708, USA
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17
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Jiménez-Gonzalo L, Romero-Moreno R, Pedroso-Chaparro MDS, Gallego-Alberto L, Barrera-Caballero S, Olazarán J, Losada-Baltar A. Psychometric properties of the Insomnia Severity Index in a sample of family dementia caregivers. Sleep Med 2021; 82:65-70. [PMID: 33901927 DOI: 10.1016/j.sleep.2021.03.036] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 03/13/2021] [Accepted: 03/26/2021] [Indexed: 10/21/2022]
Abstract
STUDY OBJECTIVES Family caregivers of people with dementia frequently report sleep problems that are linked to depressive and anxious symptoms. However, data are needed regarding the psychometric properties of specific measures of sleep problems in caregiving populations. The aim of this study is to analyse the psychometric properties of the Insomnia Severity Index (ISI; Morin, 1993) in a Spanish dementia caregiver sample. METHODS 271 participants took part in face-to face interviews where, along with sociodemographic variables, caregivers' sleep problems, depressive and anxious symptoms were measured. The psychometric properties of the ISI were analysed through Confirmatory Factor Analysis (CFA) and analysis of the internal consistency and convergent and criterion validity. RESULTS The Spanish version of the Insomnia Severity Index showed adequate indices of internal consistency (Cronbach's alpha = 0.78) in our sample of family caregivers of people with dementia. A one-factor structure provided a better fit to the data than two- and three-factor structures. The ISI was significantly associated with lower sleep quality, less average sleep time per day and lower self-perception of vitality, as well as with higher depressive and anxious symptoms. Differences in ISI scores were found between people with and without depressive and anxious symptoms. Statistically significant gender-based differences in sleep problems were also found, with female caregivers showing higher sleep problems. CONCLUSIONS The ISI is a reliable and valid instrument to assess the subjective severity of sleep problems in the family dementia caregiver population and may be a useful instrument in intervention and research settings. Additional evidence was also provided of the importance of considering sleep problems in the studied population.
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Affiliation(s)
| | | | | | | | | | - Javier Olazarán
- Service of Neurology, HGU Gregorio Marañón, Madrid, Spain; Maria Wolff Foundation, Madrid, Spain
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18
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Zou X, Liu S, Li J, Chen W, Ye J, Yang Y, Zhou F, Ling L. Factors Associated With Healthcare Workers' Insomnia Symptoms and Fatigue in the Fight Against COVID-19, and the Role of Organizational Support. Front Psychiatry 2021; 12:652717. [PMID: 33841214 PMCID: PMC8032945 DOI: 10.3389/fpsyt.2021.652717] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 03/01/2021] [Indexed: 12/22/2022] Open
Abstract
Background: Healthcare workers (HCWs) have been exposed to increased risks of insomnia and fatigue during the COVID-19 pandemic. In this study, we identify important risk factors associated with insomnia symptoms and fatigue among HCWs, and evaluate the effect of organizational support on insomnia and fatigue symptoms. Methods: This is an online cross-sectional survey of HCWs in China administered during the COVID-19 epidemic (from February 27, 2020 to March 12, 2020). We employed the AIS-8 scale for insomnia screening, and a self-reported ten-point scale to evaluate subjects' degrees of fatigue. We also designed a four-point scale to assess the degree of social support provided on an organizational level. Additionally, we conducted logistic regression analysis to identify risk factors. Results: This study included a total of 3,557 participants, 41% of which consisted of non-frontline HCWs and 59% of which was frontline HCWs. Of the non-frontline HCWs, 49% reported insomnia symptoms, and 53.8% reported a moderate to high degree of fatigue. Meanwhile, among the frontline HCWs, the percentages for insomnia and moderate to high fatigue were 63.4% and 72.2%, respectively. Additionally, frontline HCWs and HCWs employed at Centers for Disease Control and Prevention (CDCs) had elevated risks of insomnia and fatigue. However, with increased organizational support, insomnia symptoms decreased among frontline HCWs. Also, organizational support mitigated the positive correlation between daily working hours and degree of fatigue among HCWs. Conclusion: Frontline HCWs and staff in Chinese CDCs have been at a high risk of insomnia symptoms and fatigue during the fight against COVID-19. This study provides evidence for the positive effects of organizational support in relation to insomnia and fatigue among HCWs. This sheds light on government responses to the COVID-19 epidemic for other countries.
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Affiliation(s)
- Xia Zou
- Global Health Research Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Shaokun Liu
- Department of Information, Sun Yat-sen University Cancer Center, Sun Yat-sen University, Guangzhou, China
| | - Jie Li
- Global Health Research Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Wen Chen
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jiali Ye
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yuan Yang
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Fenfen Zhou
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Li Ling
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
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19
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Halsøy Ø, Johnson SU, Hoffart A, Ebrahimi OV. Insomnia Symptoms in the General Population During the COVID-19 Pandemic. Front Psychiatry 2021; 12:762799. [PMID: 34803771 PMCID: PMC8602186 DOI: 10.3389/fpsyt.2021.762799] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 10/12/2021] [Indexed: 11/13/2022] Open
Abstract
This empirical study aims to investigate factors associated with insomnia symptoms during the COVID-19 pandemic in 4,921 Norwegian adults. Participants were queried across two time-points, between March 31st and April the 7th 2020, and between June 22nd and July 13th, 2020. Relevant risk factors and psychological correlates at the first time-point and insomnia symptoms were measured 3 months later, allowing for the investigation of concurrent associations as well as associations across time. Insomnia symptoms were measured with the Bergen Insomnia Scale. The results revealed that individuals reported higher mean levels of insomnia symptoms during the COVID-19 lockdown, compared to pre-pandemic surveys from 2008 (p < 0.0001, Cohen's d = 0.29). Individuals who predominantly socially distanced reported higher mean levels of insomnia symptoms than those who did not predominantly distance. Females, individuals with lower education levels, individuals who had lost their job, and individuals who declared having been diagnosed with an unspecified pre-existing psychiatric disorder reported the most symptoms. The regression model (R2 = 0.44) showed that physical exercise, was associated with less symptoms of insomnia. Symptoms of health Anxiety, symptoms of depression, unhelpful coping strategies, worry about job and economy, and older age were all associated with higher levels of insomnia symptoms. These findings highlight particularly vulnerable subgroups, as well as providing clinicians with key areas of intervention to help individuals suffering from insomnia symptoms.
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Affiliation(s)
- Øyvind Halsøy
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Sverre Urnes Johnson
- Department of Psychology, University of Oslo, Oslo, Norway.,Modum Bad Psychiatric Hospital, Vikersund, Norway
| | - Asle Hoffart
- Department of Psychology, University of Oslo, Oslo, Norway.,Modum Bad Psychiatric Hospital, Vikersund, Norway
| | - Omid V Ebrahimi
- Department of Psychology, University of Oslo, Oslo, Norway.,Modum Bad Psychiatric Hospital, Vikersund, Norway
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20
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Gibson R, Gander P. Factors associated with the sleep of carers: A survey of New Zealanders supporting a family member with cognitive impairment or dementia. DEMENTIA 2020; 20:919-935. [PMID: 32228061 DOI: 10.1177/1471301220915071] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Sleep is important for healthy ageing. Data are limited concerning the sleep and health of New Zealand families affected by cognitive impairment or dementia. This postal survey asked about the sleep of 526 family carers and explored predictors of, and outcomes associated with poorer sleep. Linear and binominal logistic regression were used to identify independent predictors and outcomes of carers' sleep status. Using the Insomnia Severity Index, 23.5% of carers scored in the moderate-severe range and 43.0% in the mild range for sleep disturbance. More than a quarter indicated that their family member had difficulties falling asleep, getting up during the night, or waking too early. Over half of care recipients were considered to sleep too much during the day. Independent predictors for carers' reporting greater sleep disturbance included being female, caregiving at night, poorer self-rated health, and the care recipient having more disturbed sleep. Moderate-severe sleep disturbance was independently associated with poorer self-rated health and living standards, use of sleeping medications, as well as considering transitioning their family member into formal care within the year. These findings have implications for the wellbeing and trajectory of family carers as well as for health and aged care services.
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Affiliation(s)
- Rosemary Gibson
- Sleep/Wake Research Centre, Massey University, Wellington, New Zealand
| | - Philippa Gander
- Sleep/Wake Research Centre, Massey University, Wellington, New Zealand
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21
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Gök D, Ünal İ, Aslan K. Sleep disorders in a shift worker population sample in Turkey. NEUROL SCI NEUROPHYS 2020. [DOI: 10.4103/nsn.nsn_29_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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22
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Schmidt RE, Courvoisier DS, Cullati S, Kraehenmann R, der Linden MV. Too Imperfect to Fall Asleep: Perfectionism, Pre-sleep Counterfactual Processing, and Insomnia. Front Psychol 2018; 9:1288. [PMID: 30131735 PMCID: PMC6090461 DOI: 10.3389/fpsyg.2018.01288] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Accepted: 07/05/2018] [Indexed: 11/13/2022] Open
Abstract
Previous research suggests that certain dimensions of perfectionism are associated with insomnia. However, the exact processes whereby perfectionism may influence sleep have as yet remained unexplored. The present study tested the hypothesis that perfectionistic individuals are particularly prone to engage in counterfactual thinking and to experience counterfactual emotions (regret, shame, and guilt) at bedtime, which have been shown to impair sleep. One hundred eighty university students completed questionnaires on perfectionism, counterfactual processing, and insomnia severity. Analyses revealed that three dimensions of perfectionism were significantly related to insomnia severity: Concern over mistakes and doubts about action showed positive correlations, whereas organization showed a negative correlation. Moreover, the frequency of counterfactual thoughts and emotions at bedtime largely mediated the effects of these dimensions of perfectionism on insomnia severity. These findings highlight how personality-related patterns of behavior may translate into affective arousal at bedtime, thereby increasing the risk of insomnia.
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Affiliation(s)
- Ralph E Schmidt
- Cognitive Psychopathology and Neuropsychology Unit, Department of Psychology, University of Geneva, Geneva, Switzerland.,Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Delphine S Courvoisier
- Department of General Internal Medicine, Rehabilitation and Geriatrics, University of Geneva, Geneva, Switzerland
| | - Stéphane Cullati
- Department of General Internal Medicine, Rehabilitation and Geriatrics, University of Geneva, Geneva, Switzerland.,Swiss National Centre of Competence in Research "LIVES - Overcoming Vulnerability: Life Course Perspectives", Institute of Demography and Socioeconomics, University of Geneva, Geneva, Switzerland
| | - Rainer Kraehenmann
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Martial Van der Linden
- Cognitive Psychopathology and Neuropsychology Unit, Department of Psychology, University of Geneva, Geneva, Switzerland
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