Behavioral Sleep Medicine最新文献

Objective: This study aimed to develop a short form of the Korean version of the Sleep-Related Behaviors Questionnaire (SRBQ) and assess its validity and psychometric properties.

Method: We collected 300 responses from the EMBRAIN survey system and conducted exploratory and confirmatory factor analyses to group SRBQ items based on response similarity. The most representative item from each group was selected using eXtreme Gradient Boosting (XGBoost). The psychometric properties of the final 10 items were assessed using the Rasch model of item response theory (IRT).

Results: Based on the selected 10 key items, we developed the SRBQ-10-a data-driven shortened version of the SRBQ, which demonstrated excellent performance (0.96) in predicting the SRBQ score, despite having only 10 items, which is one-third of the items in the original SRBQ-32. In addition to its reliability, the photometric properties of the SRBQ-10 were in the theoretically expected order, with no overlap or reversal of scale order, confirming the validity of the item scale.

Conclusion: The SRBQ-10, a concise version of SRBQ, enables efficient screening of sleep-related behaviors in clinical settings. Our study framework combining classical test theory, XGBoost, and IRT can be applied to develop and validate shorter versions of other questionnaires.

Objective: This study assessed the effects of cognitive therapy (CT) for depression on insomnia in women with metastatic breast cancer.

Methods: Thirty-four women with metastatic breast cancer and depressive symptoms were randomly assigned to CT for depression or a waitlist control group (WLC). Insomnia was measured using the Insomnia Severity Index (ISI) at pre-treatment (PRE) and posttreatment (POST), as well as 3 (FU3) and 6 (FU6) months later.

Results: In the CT group, the proportion of women obtaining a clinically significant level of insomnia (ISI ≥8) decreased significantly from pre- to posttreatment (PRE = 80.0%; POST = 26.7%; p = .013). The mean ISI score differed significantly between groups at posttreatment/waiting (intervention = 5.5; control = 12.7; p = .048) and the ISI score decreased significantly from pre- to posttreatment (PRE = 11.5; POST = 5.5; p = .001). Additional analyses were performed pooling both groups together after WLC patients received CT. The proportion of patients with a clinical level of insomnia (PRE = 77.5%; POST = 28.3%; FU3 = 46.3%; FU6 = 21.0%; p < .0001), and the mean ISI score significantly decreased over time(PRE = 12.1; POST = 5.0; FU3 = 8.0; FU6 = 5.5; p < .0001).

Conclusions: Although insomnia improved over time, 21.0% to 46.3% of women reported residual insomnia symptoms following CT for depression. Therefore, a concomitant treatment that directly targets insomnia should be provided to women with cooccurring depression and insomnia.

Objectives: We developed and evaluated the psychometric properties of the Sleep Acceptance Scale (SAS), a tool designed to measure sleep acceptance via cognitive and emotional responses to sleep problems.

Method: We designed a six-item scale, rated on a 7-point Likert scale, to capture the nuances of sleep acceptance. Data were collected from 1,350 participants, both with and without sleep problems. We employed an Exploratory Graph Analysis (EGA) and a Confirmatory Factor Analysis (CFA) to assess internal consistency, convergent validity, and measurement invariance over time and between groups.

Results: The EGA revealed a unidimensional structure for the SAS, which the CFA also confirmed. However, the root mean square error of approximation was marginally above the ideal threshold. The scale demonstrated high internal consistency (${\omega }_{\mathrm{tot}}$ = 0.91) and strong correlations with measures of insomnia severity, anxiety, depression, and willingness, supporting its convergent validity. Although the SAS maintained temporal stability over 14 days, it lacked configural invariance between good and bad sleepers, suggesting potential differences in how sleep acceptance manifested across these groups.

Conclusions: The SAS effectively measures sleep acceptance, capturing important cognitive and emotional dimensions. It can be used to monitor progress in acceptance and commitment therapy and mindfulness-based interventions.

Objectives: Cognitive behavioral therapy for insomnia (CBT-I) is the recommended first-line treatment for insomnia. However, patients with objective short sleep duration may show a reduced response to CBT-I and require alternative or additional treatment.This study investigated the effect of objective and subjective short sleep duration before treatment on response to CBT-I in patients with chronic insomnia.

Methods: We analyzed chart-review data from 446 patients with chronic insomnia (66.6% female, age M = 51.6 ± 15.6 years) treated with a 5-6 session CBT-I program in a sleep clinic. Short sleep duration was assessed from single-night polysomnography ( < 6 h:n = 254; ≥6 h:n = 178) and oneweek of sleep diaries ( < 6 h:n = 229; ≥6 h:n = 124). Mixed models tested for differences between sleep duration groups on changes in sleepdiary outcomes and daytime functioning questionnaires at post-treatment and three-month follow-up.

Results: Short objective sleep duration predicted reduced improvements in daytime functioning (p = .019) and depression (p = .04), but no other outcomes. Short subjective sleep duration predicted greater improvement in all sleep diary outcomes (all p < .001). Results were consistent across sensitivity analyses.

Conclusions: Objective and subjective sleep duration predicted some, mostly small, differences in treatment response to CBT-I in patients with chronic insomnia. That said, patients with short or normal sleep durations benefitted from CBT-I.

Background: Sleep-disordered breathing (SDB) is common in ischemic stroke patients and may influence recovery and long-term outcomes. This systematic review and meta-analysis aims to evaluate the impact of SDB on clinical outcomes of ischemic stroke including complications, cognitive impairment, hospitalization, recurrent stroke, and mortality.

Methods: A systematic search of PubMed, Embase, and Scopus databases was conducted to identify observational studies examining the relationship between SDB and outcomes in ischemic stroke patients. Random-effect models were used to calculate pooled odds ratios (ORs) with 95% confidence intervals (CIs). Heterogeneity was assessed using the I² statistic.

Results: A total of 30 observational studies were included. SDB was associated with significantly higher odds of hospitalization (OR: 6.14, 95% CI: 1.35-27.97) and mortality (OR: 3.39, 95% CI: 1.15-9.98). Moderate-to-severe SDB (AHI > 15) was linked to a higher incidence of adverse outcomes (OR: 1.03, 95% CI: 1.01-1.05). However, no significant associations were found for cognitive impairment (OR: 1.05, 95% CI: 0.73-1.51), complications (OR: 1.14, 95% CI: 0.84-1.55), or recurrent stroke (OR: 1.02, 95% CI: 0.19-5.47).

Conclusions: SDB significantly increases the risk of hospitalization and mortality in ischemic stroke patients. Early identification and management of SDB could improve clinical outcomes, though further research is needed to explore causal relationships and optimize interventions.Prospero Registration Number: CRD42024612023.

Methods: In Study 1, 349 Turkish-speaking adults (57% female; M = 24.05 years, range = 18-68) completed the translated Vamping Scale with related sleep and procrastination measures. CFA, item-total correlations, and IRT assessed factor structure and item properties, while reliability was evaluated with α, ω, and λ6. In Study 2, 342 adults (56% female; M = 26.65 years, range = 18-56) completed the Vamping Scale with mental health and well-being measures. Pearson correlations and SEM tested whether psychological distress mediated the relationship between vamping and well-being.

Results: A revised 10-item, two-factor model showed acceptable fit (CFI = .901; SRMR = .0562) and high internal consistency (α = .890). Vamping was positively related to bedtime procrastination, sleep effort, and psychological distress, and negatively to life satisfaction and well-being. SEM confirmed psychological distress mediated the link between vamping and well-being.

Conclusion: The Turkish Vamping Scale is a psychometrically sound instrument for assessing late-night technology use behaviors in adult populations. The findings underscore the detrimental associations between vamping, sleep-related difficulties, and psychological distress, supporting the need for targeted interventions. Future research should incorporate longitudinal designs and objective sleep measures to clarify causal pathways.

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.