Behavioral Sleep Medicine最新文献

Objectives: This pilot study aimed to preliminarily assess the effectiveness of Acceptance and Commitment Therapy (ACT) vs. Motivational Interviewing (MI) in battling sleep disturbances and academic procrastination among Malaysian undergraduates.

Method: In this single-blind, quasi-experimental study, thirty undergraduate students were randomly assigned to either six online therapist-led Acceptance and Commitment Therapy (ACT) sessions (n = 15) or six online therapist-led Motivational Interviewing (MI) sessions (n = 15). The Tuckman Procrastination Scale, Pittsburgh Sleep Quality Index, and Psy-Flex were administered at baseline, the end of session 3, session 6, and one-month follow-up.

Results: Participants in both groups showed significant improvement in academic procrastination, sleep disturbances, and psychological flexibility(p < .001, η² = .62), with outcomes improved progressively after three sessions, six sessions, and at the one-month follow-up. There was no statistically significant difference between the effectiveness of ACT and MI.

Conclusions: This novel study provides preliminary support for the application of ACT and MI in reducing academic procrastination and sleep disturbances concurrently among undergraduates, with a greater number of sessions leading to better outcomes.The comparable effectiveness of both therapies implies possible flexibility in clinical practice, enabling practitioners to select an intervention based on factors like student preferences, therapist expertise, and resource availability. Future studies should explore the mechanisms and moderating factors influencing the effectiveness of these interventions through well-designed randomized controlled trials (RCTs) with larger sample sizes.

Objectives: The study objective was to examine the impact of a brief behavioral sleep intervention (The Sleep Train Program) on sleep and behavior in children with externalizing behavior problems.

Method: Children (3-8 years) presenting to a behavioral health clinic for externalizing problems were randomized to receive a behavioral sleep intervention or a mealtime intervention (active control). Families then completed parent management training followed by the cross-over intervention. Outcomes included parent-reported child sleep and behavior and actigraphic sleep, and were examined in the full sample and in a subsample of children with comorbid sleep difficulties.

Results: In a subsample of children with both externalizing and sleep difficulties, children randomized to behavioral sleep intervention showed reduced externalizing problems (t = -2.75, p < .05), reduced night wakings (t = -2.21, p < .05), and improved parent-child interactions (t = 2.99, p = .01) and child behavior (t = -2.42, p < .05) at bedtime, compared to active control. In the full sample, in which some children did not present with sleep difficulties, behavioral sleep intervention, compared to active control, did not yield significant improvements in most sleep and behavior outcomes. Comparing sleep and behavior before and after behavioral sleep intervention across groups, children had fewer externalizing behaviors (t = 4.98, p < .001), improved sleep habits (t = -3.24, p < .05) and improved parent-child bedtime interaction (t = -3.24, p < .01), but no changes in sleep patterns.

Conclusion: A brief behavioral sleep intervention was efficacious in improving both sleep and behavior outcomes for children with comorbid sleep and externalizing difficulties, but not for children with only externalizing difficulties.

Objectives: Chronic insomnia (CI), the most common sleep disorder in young children, is associated with negative outcomes for the child and family. This study explores the beliefs, current practice, and understanding of UK primary health care professionals (PCPs) regarding CI in children under 5 years.

Method: An online survey of UK PCPs (e.g. general practitioners (GPs), practice nurses) recruited through Clinical Research Networks. The survey consisted of Likert-style and closed- questions regarding beliefs, current practice, and training/knowledge. Data were analyzed descriptively.

Results: Two hundred and ninety-five PCPs took part (mostly GPs, n = 244). Respondents believe that CI has a large impact on children and family. 80% agreed that CI should be managed in health care and 66.3% in primary care. However, consultations with families regarding CI were reported as infrequent. 91.6% agreed that CI should be managed with behavioral approaches, and more than  85% of respondents recommend positive bedtime routines. Respondents had varied confidence and knowledge about management. They had received little to no professional education about CI.

Conclusions: PCPs recognize the importance of CI and understand some principles of management, though they lack training and confidence. Improved training and awareness of evidence-based resources for support would improve management in primary care.

Objectives: This study sought to characterize the sleep of youth athletes and investigate relationships between sleep measures and cognitive function.

Method: Youth netball athletes (n = 19, age; 16.58 ± 1.26 years), wore an Actigraph wGT3X-BT and completed a daily sleep diary over 8 weeks. Cognitive function was measured every 2 weeks using Inquisit online software. Data were analyzed using generalized estimating equations to investigate the relationship between sleep and cognitive function.

Results: Youth athletes averaged <7 hr of sleep each night. Increases in total sleep time (β= -.13, CI [-.21, -.06]) sleep efficiency (β= -.49, CI [-.87, -.11]) and sleep quality rating (β= -12.23, CI [-21.26, -3.20]) resulted in a decrease in reaction time (p < .05). Increases in sleep onset latency (β= .04, CI [.02, .06]) and wake after sleep onset (β= .03, CI [.01, .05]) resulted in an increased error count for the digit symbol substitution task (p < .05).

Conclusion: Findings show that many youth athletes obtain less than the recommended amount of sleep. This is concerning given the importance of sleep for adolescent development. Inadequate sleep in youth athletes appears to negatively affect cognitive function. Future research should investigate the impact of inadequate sleep in youth athletes on athletic and academic performance.

Objectives: Research supports cognitive behavioral therapies for nightmares (CBT-N) in adults. However, the nuances of implementation and unstandardized nomenclature for treatment components has created confusion in the field. To provide clarification, an expert consensus panel convened to review treatment manual components and to develop guidelines for the standardized implementation and terminology of CBT-N. The aims of this paper are to report on the expert panel recommendations.

Methods: A literature review was conducted for nightmare treatment manuals that have been tested in randomized clinical trials with adults. the panel of experts evaluated the content and the main controversies regarding treatment components. The panel then established recommended treatment guidelines based on the literature and clinical experience.

Results: Recommendations pertain to which patient symptom presentations are appropriate for CBT-N and considerations for implementing treatment components including session length, relaxation training, stimulus control, sleep efficiency training, sleep hygiene, nightmare exposure, nightmare rescripting, and imagery rehearsal of rescripted dreams. The panel evaluated treatment components to inform the development of a consensus CBT-N treatment manual.

Conclusions: Using a comprehensive treatment manual based on expert recommendations will not only help disseminate nightmare treatment but also advance the field by providing clarity. These recommendations are based on the status of the field and will need to be revised to incorporate developing research evidence in nightmare treatment.

Objectives: Cognitive Behavioral Therapy for Insomnia (CBT-I) is recommended as the first-line treatment for insomnia disorders, yet its clinical application rate ranges from 1% to 29%. This study evaluated medical doctors' knowledge, attitudes, and practices regarding the use of CBT-I in treatingpatients with insomnia.

Methods: A cross-sectional study was conducted from May 8 to 26, 2021. Data were collected using an anonymous structured self-administered questionnaire with 19 questions. Multivariable logistic regression analysis identified factors influencing doctors' recommendations of CBT-I.

Results: The sample included 1494 respondents.Of these, 27.2% knew the core components of CBT-I, 86.1% believed it was a first-line treatment, and 64.1% had recommended CBT-I. The analysis indicated that female respondents were less likely to recommend CBT-I (adjusted OR = 0.76, p = .045), whereas those aged 31-40 years were more likely to recommend it (adjusted OR = 2.62, p < .001). Respondents with an undergraduate degree or lower (adjusted OR = 1.36, p = .043), those knowledgeable about stimulus control (adjusted OR = 0.67, p = .01), familiar with CBT-I (adjusted OR = 0.09, p < .001), and who viewed CBT-I as a first-line treatment (adjusted OR = 0.37, p < .001) were more inclined to recommend it.

Conclusions: Medical doctors treating insomnia have positive attitudes toward CBT-I but need better knowledge. Factors influencing CBT-I recommendations include gender, age, education level, knowledge of stimulus control, familiarity with CBT-I, and viewing it as a first-line treatment. These findings highlight the need for targeted education to improve CBT-I adoption.

Background: Compared to the general population, military personnel are at increased risk for insomnia and poor psychological well-being. The present study: (1) compared categories of insomnia severity between cadets of the Swiss Armed Forces (SAF) and previously published norms and (2) investigated the associations between insomnia and psychological well-being related to perceived stress, mental toughness, dark triad traits, and organizational citizenship behavior (OCB).

Methods: A total of 216 cadets of the SAF (mean age: 20.80 years) completed self-rating questionnaires covering sociodemographic information, insomnia, perceived stress, mental toughness, dark triad, and organizational citizenship behavior. Data on insomnia sum scores and categories of historical samples (862 young adults and 533 police and emergency response service officers) were used for comparison.

Results: Cadets of the SAF reported higher insomnia sum scores and insomnia severity categories, compared to young adults and police officers. Higher scores for insomnia were associated with higher scores for stress, dark triad traits, and with lower scores for mental toughness and OCB. Categories of low, medium, and high stress moderated the association between insomnia and dark triad traits.

Conclusions: Compared to norms of the general population, cadets of the SAF reported a higher insomnia severity. Given that standardized treatment programs for insomnia, mental toughness, and above all for coping with stress are available, such interventions might be promising avenues to improve a cadet's overall sleep, psychological well-being, and behavior.

Objectives: Sleep and internalizing problems escalate during adolescence and can negatively impact long-term health. However, the directionality of this risk-relationship remains poorly understood within a developmental context. The current study aimed to determine the directionality of this relationship in adolescents with no history of psychiatric disorder and whether sex at birth played a role in this relationship.

Methods: We used data from the Adolescent Brain Cognitive Development, an ongoing multisite longitudinal US study, that covered four waves (W1:9-11 years; W2:10-12 years; W3:11-13 years; W4:12-14 years). Analyses included 3,128 youth (50.99%girls) with no past or current psychiatric disorders at W1. The Sleep Disturbance Scale for Children and the Child Behavior Checklist were used to measure sleep and internalizing problems. Cross-lagged panel models were used to evaluate the cross-lagged relationships across waves.

Results: The sleep-internalizing cross-lagged relationship was unidirectional, with medium-large effect sizes: greater total sleep problems were associated with more severe internalizing problems at later waves (W2➔W3, coefficient = 0.052, p = .021; W3➔W4, coefficient = 0.091, p < .001), with problems in initiating and maintaining sleep predicting internalizing problems early on. Girls showed greater sleep-internalizing risk than boys.

Conclusions: Sleep-internalizing relationships change across adolescence, becoming significant and more specific from early to mid-adolescence. Sleep interventions delivered in early adolescence, to girls in particular, may have a positive short and long-term impact on internalizing outcomes.