Behavioral Sleep Medicine最新文献

Narcolepsy and Idiopathic Hypersomnia (IH) are chronic sleep disorders that negatively impact the Health-Related Quality of Life (HRQoL) of those who are diagnosed with the disorders. As such, Narcolepsy and IH may also impact the HRQoL of those close to the patient (e.g. partners, parents).

Aim: This project explored the experiences of partners of people with Narcolepsy or IH, and examined how living with someone with the diagnosis had impacted their own HRQoL.

Methods: In this in-depth qualitative study, semi-structured interviews were used to collect data from eight people (4 males and 4 females, aged between 21 and 53 years old) whose partners had Narcolepsy T1, T2, or IH. The data was analyzed using Reflexive Thematic Analysis (RTA) to find common themes emerging from the participants' narratives. Self-reports for psychological distress (K10) and sleep quality (PSQI) were used.

Results: Five themes (and two sub-themes) were identified: 1) changes in dyadic identity; 2) negative impact on intimacy; 3) loneliness; 4) sacrifices to maintain the relationship, and 5) dissatisfaction at the lack of knowledge and information.

Conclusions: Partners of patients with Narcolepsy or IH reported being affected by some of the symptoms of their partners' sleep disorder. Partners' social and emotional HRQoL were the features most strongly impacted by the disorders. Future research should focus on developing collaborative care models that involve patients' partners in treatment.

Objectives: To examine the relationship between insomnia symptoms and self-injurious behaviors (SIB) among adolescents and young adults, with a focus on the mediation effects of depression and anxiety on this association.

Methods: An online survey among adolescents and young adults was conducted in Xiamen City, Fujian Province, from December 2022 to May 2023. SIB was assessed using two items from Health-Related Risky Behavior Inventory. Insomnia, depressive, and anxiety symptoms were evaluated by Insomnia Severity Index, Patient Health Questionnaire, and Generalized Anxiety Disorder Scale, respectively. A structural equation model was employed to explore the mediating role of depressive and anxiety symptoms in the relationship between insomnia and SIB.

Results: A total of 3436 participants (M_age = 18.12 years; 58.4% female) were included in final analysis, with 707 (20.6%) reporting SIB within the past 12 months. Participants with SIB exhibited higher levels of insomnia, depressive, and anxiety symptoms compared to those without SIB. Insomnia symptoms were significantly associated with SIB (β = 0.343, p < .001). Additionally, depressive (β = 0.093, p < .001) and anxiety (β = 0.026, p = .001) symptoms mediated the relationship between insomnia symptoms and SIB. Total indirect effects accounted for 79.33% of the total effects (insomnia → SIB). However, sex did not moderate the mediation effect. Sensitivity analyses yielded similar results.

Conclusion: Depressive and anxiety symptoms mediate the relationship between insomnia and SIB in adolescents and young adults, suggesting that insomnia may act as a transdiagnostic factor contributing to emotional dysregulation and SIB.

Objectives: This study examined the effects of bedroom lighting with pre-bedtime activities two hours before bedtime on sleepiness and polysomnography (PSG) sleep in community-dwelling adults with poor sleep.

Methods: A balanced crossover design was used with 24 healthy adults. Four lighting conditions under two activity situations (unrestricted (A1) and restricted (A2) electronic device use two hours before bedtime) were tested using adjustable LED lights: (E2: 3000K, 160 lux; E3: 5000K → 3000K, 160 → 30 lux; E4: 5000K, 160 lux) and compared to standard fluorescent lighting (E1: 5000K, 160 lux). The protocol lasted 8 nights (4 lightings × 2 activity conditions), with the whole night PSGmeasure, subjective sleep perception at wake-up, and sleepiness (Stanford Sleepiness Scale) measured hourly 2 hr before bedtime.

Results: Results showed that sleep latency was 10.62 min longer when exposed to 5000k LED light than to 5000k FL. Exposure to other lower color temperature lights did not have a significant difference in sleepiness and PSGsleep. However, participants felt drowsier and had a shorter PSG sleep latency of 6.08 min when the use of electronic devices was not allowed.

Conclusion: A 5000k LED light leads to longer sleep latency compared to a 5000k fluorescent light. Restriction of electronic device use before bedtime improves sleep onset in healthy adults. Managing ambient light exposure with lower color temperature LED light and reducing electronic device use 2 hr before bedtime may improve sleep quality in healthy adults.

Objective: To explore the attitudes and experiences of people with chronic low back pain (LBP) on sleep, health care, and digital health.

Method: Participants completed a survey about LBP, sleep, health care, and digital health. All data collected was self-reported by participants. Survey completers were invited for semi-structured interviews comprising open-ended questions exploring LBP and sleep interplay, health care experiences, and digital health preferences. Interviews were analyzed using a thematic framework approach.

Results: Six-hundred and sixty-nine participants completed the survey. n = 501 female, mean age = 56.7 ± 14.4 years. Most participants (90%) reported LBP-related sleep disturbance. More than half (61%) were not satisfied with their current LBP-related health care Sixty-one percent of participants were willing to use a sleep-specific digital health intervention (DHI) if recommended by a health care professional. Interviews (n = 26) revealed three themes: (i) living with LBP and poor sleep, (ii) health-seeking behaviors, and (iii) implementing sleep and back pain DHIs. Participants were concerned with the legitimacy of non-health professional advice and preferred evidence-based DHIs.

Conclusions: Sleep disturbance and health care dissatisfaction was highly prevalentin individuals with chronic LBP. Participants were willing to use evidence-based self-directed DHIs for LBP and sleep disturbance management but wanted clinical authority. These findings reveal opportunities for clinical implementation and intervention studies for individuals with chronic LBP and sleep disturbance.

Objective: Research on the prevalence of bedtime procrastination (BtP) is currently focused on the breadth of BtP presentations, with limited insights into the severity of BtP in terms of its frequency, duration, and dysfunctional impacts. This study aimed to explore the BtP severity and its prevalence among Chinese college students. Moreover, correlates and outcomes of BtP were also examined.

Methods: A total of 20704 college students participated in a cross-sectional survey. BtP was measured by combining the bedtime procrastination scale with items related to BtP frequency, duration per episode, and dysfunctional impacts. Sociodemographics, lifestyles, trait- and state-like factors, and indicators of sleep and mental health were also evaluated.

Results: The prevalence of severe BtP was 10.5%. Poor family socioeconomic status, physical inactivity, alcohol use, pre-sleep media use, and perceived stress were identified as risk factors for severe BtP, while older age, self-control, and an earlier chronotype were protective factors. Moreover, severe BtP was associated with shorter sleep duration, greater social jetlag, and increased risks of daytime sleepiness and depressive symptoms.

Conclusions: The findings provided valuable insights for BtP screening. The associations between BtP and adverse outcomes underscore the importance of screening for severe BtP and offering appropriate interventions.

Objectives: This study investigated cross-country differences in infant and maternal sleep across Korea, the U.S.A. and Australia.

Methods: Participants were 2,005 mother-infant dyads (infant M_age = 13.82 months, SD_age = 6.23 months) from Australia (n = 73), Korea (n = 222), and the U.S.A. (n = 1710). Mothers completed the Insomnia Severity Index (ISI), Dysfunctional Beliefs and Attitudes About Sleep Scale (DBAS), and Brief Infant Sleep Questionnaire (BISQ) and were grouped (6, 12, and 24 months) dependent on infant age. Data were analyzed using multiple regressions.

Results: Korean mothers had higher insomnia symptoms compared to Australian and U.S.A. mothers at all timepoints (p's < .002). Mean DBAS scores were higher for Korean compared to U.S.A. and Australian mothers (p's < .007). Compared to U.S.A. infants at all timepoints and to Australian infants at 12- and 24 months, Korean infants had shorter nighttime TST (p's < .040) and longer SOL (p's < .003). Bedsharing was associated with lower insomnia symptoms in Korean mothers at 24 months (p = .043). Co-sleeping was not significantly associated with insomnia and DBAS scores (p's > .164).

Conclusions: Korean mothers had higher insomnia and DBAS scores, which did not differ by co-sleeping status; Korean infants had shorter nighttime TST, and longer SOL. Bedsharing in Korea was protective against insomnia symptoms at 24 months. Further exploration into the mechanisms of sleep changes is required to tailor future interventions for diverse backgrounds.

Objectives: Insomnia is common for women with breast cancer, and related to fatigue, depression, and pain. Research exploring these symptoms among breast cancer patients in medically underserved areas is lacking. This study aimed to characterize symptom severity, and examine how fatigue, depression, and pain vary based on categories of insomnia severity.

Methods: Women (N = 127) with Stage 0-IV breast cancer receiving care at clinics in mostly rural, medically underserved areas completed self-report measures of insomnia (Insomnia Severity Index), fatigue (PROMIS-Fatigue), depression (Center for Epidemiological Studies Depression Scale), and pain (Brief Pain Inventory). ANOVA or Kruskal-Wallis tests compared differences in fatigue, depression, and pain across insomnia severity categories. Post-hoc tests determined pairwise significant differences. Analyses were conducted using SAS software.

Results: Median [IQR] insomnia symptom severity fell within the Subthreshold/Mild range (12.00 [6.00, 16.00]). Thirty-four percent of women endorsed insomnia symptoms in the Moderate range or higher. Median fatigue was moderate (60.80 [55.60, 64.85]), and median depressive symptoms (17.00 [10.50, 23.50]) indicated risk for clinical depression. Mean pain severity (4.59 [1.85]) and median pain interference (4.29 [2.57, 6.46]) were moderate. Women endorsing Subthreshold/Mild and Moderate/Severe insomnia symptoms exhibited significantly worse fatigue, depressive symptoms, and pain.

Conclusions: Results highlight a multi-symptom burden for women with breast cancer receiving care at clinics in medically underserved areas with a largely rural population. Behavioral symptom management is critically needed. Intervening on insomnia may, in turn, improve fatigue, depression, and pain. Behavioral interventions targeting insomnia and related symptoms should be adapted for, and tested, in this population.

Objectives: This study aimed to determine the extent to which Cognitive Behavioral Therapy for Insomnia (CBT-I) influences participant willingness to seek treatment for behavioral health conditions. We hypothesized that, relative to sleep hygiene control, CBT-I would be associated with increased willingness to seek treatment for alcohol use, depression, anxiety, PTSD, and chronic pain. Since all participants had insomnia, we also tested CBT-I effects on willingness to seek treatment for residual or future episodes of insomnia.

Method: Data were derived from a randomized controlled trial comparing the efficacy of CBT-I to sleep hygiene control among heavy-drinking Veterans with insomnia (N = 70; 57 men, 13 women; age M = 37.6, SD = 9.4). Willingness to seek treatment was measured on a scale from 0 (strongly disagree) to 4 (strongly agree).

Results: At the end of treatment, across both groups, participants reported most willingness to seek treatment for insomnia (M = 3.08, SD = 1.04), followed by chronic pain (M = 2.82, SD = 1.21), anxiety (M = 2.76, SD = 1.24), depression (M = 2.75, SD = 1.29), PTSD (M = 2.61, SD = 1.27), and alcohol use (M = 2.51, SD = 1.19). Relative to those in sleep hygiene, CBT-I participants reported increased willingness to seek treatment for insomnia [F(1,48) = 10.25, p = .002, d = 0.86] and chronic pain [F(1,48) = 5.76, p = .02, d = 0.60]. No other group-by-time interactions were significant.

Conclusions: CBT-I does increase willingness for future treatment, but only targeting insomnia and chronic pain. Continued research on how to engage Veterans in evidence-based treatment for common mental health concerns (e.g. alcohol use, depression, anxiety, and PTSD) is needed.

Background: Insomnia and its association with mental health problems are prevalent in young populations. While person-centered statistical methods have identified insomnia phenotypes using a wide range of variables, the potential of common screening tools like the Insomnia Severity Index (ISI) for subtyping insomnia is underexplored. This study aimed to investigate insomnia subtypes in university students using ISI items.

Methods: In a cross-sectional online survey, 1,234 Italian university students (mean age: 23.3 ± 2.4 years) completed the ISI, the Pittsburgh Sleep Quality Index, the Depression Anxiety Stress Scale, and the Short Form-12 health survey. Latent class analysis (LCA) was performed using ISI items as indicators, and class differences in sleep quality, psychological distress, and health-related quality of life were assessed.

Results: A four-class solution was identified: "no insomnia" (NI; 31.4%) with no significant sleep complaints; "high insomnia risk" (HI; 17.7%) showing severe nighttime and daytime symptoms; "subthreshold insomnia" (SI; 37.0%) characterized by moderate nighttime symptoms and sleep dissatisfaction; and "predominant daytime symptoms" (DS; 13.9%) featuring pronounced daytime dysfunction without major nighttime issues. The HI group exhibited the worst sleep quality and highest psychological distress. NI had the best overall outcomes, with SI and DS in intermediate positions. DS had worse mental well-being, higher daytime dysfunction, and more psychological distress compared to SI.

Conclusion: LCA identified four insomnia subtypes based on ISI scores, delineating a continuum from no insomnia to high risk, with one subtype marked primarily by daytime impairments. These findings could guide tailored interventions for different clinical presentations.