Behavioral Sleep Medicine最新文献

Objectives: In this meta-regression, we aimed to explore associations between changes in psychosocial factors and changes in sleep disturbance during mindfulness-based interventions (MBIs). We also investigated participant-specific and methodological factors associated with sleep disturbance during MBIs.

Method: We utilized data from a published meta-analysis of 40 randomized controlled trials of MBIs (published from inception to 2020) with a sleep disturbance outcome measure in healthy and clinical adult populations. We conducted meta-regressions to test associations between sleep improvements following MBIs and psychosocial factors, as well as demographic and methodological factors.

Results: MBIs were associated with significant reductions in sleep disturbance (SMD = -0.523; 95% CI = -0.678 to -0.368) and psychosocial factors (SMD = -0.213 - -0.894). Reductions in sleep disturbance were associated with reductions in stress (r = 0.74, p = .02) and depression (r = 0.90, p < .001).

Conclusions: MBIs improve sleep disturbance across a wide range of healthy and clinical populations. Stress and depression may be important psychosocial factors associated with sleep disturbance. Future RCTs should include measures of additional factors and should investigate longitudinal associations between psychosocial, demographic, and methodological factors with changes in sleep disturbance to test mechanisms and to identify "active ingredients" of MBIs.

Objectives: Bedtime procrastination has been identified as an important factor associated with insufficient sleep and health and well-being problems. This study aims to investigate factor structure and psychometric properties of Bedtime procrastination Scale (BPS) in the Persian-speaking community. Additionally, this research aims to examine the role of bedtime procrastination in predicting sleep-related problems.

Method: Four hundred and thirty-three participants (average age 23 years, 55.7% female) took part in this study. All participants completed the BPS, the Insomnia Severity Index (ISI), and the Tuckman Procrastination Scale (TPS). Confirmatory factor analysis and hierarchical regression analysis were used to examine the factor structure and predict sleep-related problems.

Results: Confirmatory factor analysis showed that, unlike other language versions, the two-factor model without item 3 was the most suitable structure. This scale demonstrated acceptable reliability and validity. Additionally, the results of hierarchical regression analysis indicated that the procrastination factor, especially bedtime procrastination, was the best predictor of insomnia severity.

Conclusion: In this study, the Persian version of BPS showed strong validity and reliability. These findings suggest that the Persian BPS can serve as a valuable and comprehensive research tool for assessing bedtime procrastination.

Objectives: A preference for eveningness - one's perception of being most alert later in the day - is associated with negative developmental outcomes in adolescence. Sleep onset consistency is protective against such outcomes. Toward a more nuanced understanding of relations between sleep-wake processes and adolescent development, we examined weeknight sleep onset consistency as a moderator of relations between eveningness and multiple indicators of development.

Method: A sample of 272 high-school students (M_age = 17 years, SD = 9.12 months; n = 133 identified as female; 41% non-Hispanic Black/African-American, 59% non-Hispanic White/European-American) participated in a week of at-home sleep actigraphy assessment in 2017-2018. Adolescents reported their morningness - eveningness, internalizing symptoms (depression, anxiety), positive affect (optimism and subjective happiness), and physical health, and mothers reported on youths' behavior problems. Relations were examined between morningness - eveningness and each indicator of development; sleep onset consistency was examined as a moderator of these associations.

Results: On average, adolescents with a preference for eveningness had higher levels of externalizing behaviors and internalizing symptoms and lower levels of positive affect and physical health compared to peers with a preference for morningness (Bs = -0.27*-0.12***). Each association was moderated by weeknight sleep onset consistency. Across all indicators of development, evening-preferring youth with more consistent weeknight sleep onset had 0.49-0.72 SD better outcomes on average than evening-preferring youth with less consistent weeknight sleep onset.

Conclusions: Falling asleep at roughly the same time each night can protect adolescent night owls from behavior problems and internalizing symptoms and can promote their positive affect and physical health.

Objectives: This study aimed to investigate the factors affecting patient perceptions of sleep concerns and the need for treatment to understand and enable effective management.

Methods: This cross-sectional study analyzed data collected between November 2018 and October 2022 at the sleep clinic of a tertiary hospital. Adults aged > 19 years who completed sleep questionnaires and polysomnography (PSG) were included. Logistic regression models were used to assess the associations between demographic, clinical, and social factors, sleep questionnaire responses, and PSG data with self-reported sleep concerns (n = 3,457) and perceived need for treatment(n = 3,135).

Results: Insomnia-related symptoms affect both sleep concerns and need for treatment, and sleep maintenance is the most influential factor in both sleep concerns (odds ratio[OR] = 19.74, 95% confidence interval[CI] 6.17-63.20) and need for treatment (OR = 3.84, 95% CI 2.19-6.73). Young age (OR = 2.66, 95% CI 1.38-5.12), employment status, and daily life dysfunction were determinants of treatment readiness. None of the PSG parameters showed an independent association with sleep concerns or need for treatment.

Conclusions: Sleep maintenance problems had the most profound effect on sleep concerns and the need for treatment. Social needs are key factors in seeking treatment. A discrepancy has been noted between the effects of subjective and objective factors on sleep concerns and the need for treatment; therefore, patient management should pay attention to subjective sleep complaints.

Objectives: This study aimed to investigate relationships between lucid dreaming and sleep and mental health outcomes within a representative sample of the general population. We also sought to examine how nightmares interact with the relationship between lucid dreaming, sleep, and mental health outcomes.

Methods: Participants (N = 1332) completed measures of lucid dream frequency, nightmare frequency, anxiety and depressive symptoms, stress, and sleep quality. Hierarchical regression models were conducted, where step-1 examined the direct effect of lucid dreaming on all outcome variables, and step-2 added nightmares into the equation (to examine direct effects of lucid dreaming frequency and nightmares, and the indirect effect of nightmares).

Results: Step-1 results demonstrated that lucid dreaming positively predicted poor sleep quality, stress, anxiety, and depressive symptoms. Step-2 results revealed that nightmares were the only significant predictor of poor sleep quality, stress, and anxiety symptoms, accounting for all of the variance of lucid dreaming. Nightmares and the interaction of nightmares and lucid dreaming positively predicted depressive symptoms.

Conclusions: Our results suggest that nightmares alone explain associations between lucid dreaming and poor sleep quality, anxiety symptoms, and stress. However, both nightmares and the combination of nightmares and lucid dreaming are associated with increased depressive symptoms.

Objectives: We assessed the reliability and validity of the Korean version of the Pain-related Beliefs and Attitudes about Sleep (PBAS) scale among patients with chronic pain. Furthermore, we investigated whether pan-related dysfunctional beliefs about sleep mediate the relationship between sleep severity and pain.

Methods: Overall, 100 participants with chronic pain were recruited using an anonymous online survey. Their demographic data and responses to pain severity rating scales, comprising the translated Korean version of the PBAS; Dysfunctional Beliefs and Attitudes about Sleep-16 (DBAS-16); Metacognition Questionnaire-Insomnia-6 (MCQI-6); and the Insomnia Severity Index (ISI), were collected.

Results: The Korean version of the PBAS scale has two-factor structure. The PBAS was a reliable scale which can measure pain-related dysfunctional beliefs about sleep among patients with chronic pain. It showed strong convergent validity with pain severity (r = 0.61, p < .001), DBAS-16 (r = 0.65, p < .001), MCQI-6 (r = 0.56, p < .001), and ISI (r = 0.68, p < .001) scores. Mediation analysis indicated that pain severity directly influenced insomnia severity, with PBAS, DBAS-16, and MCQI-6 scores partially mediating this association. Conversely, insomnia severity was associated with pain severity, with the PBAS score alone mediating this relationship.

Conclusions: The Korean PBAS is a reliable and valid rating scale which measures pain-specific, sleep-related dysfunctional beliefs among patients with chronic pain.

Objectives: Sleep disturbance is commonly reported by people with anxiety, depressive, and personality disorders, but longitudinal studies exploring the interplay of the three with disturbed sleep have not previously been described.

Methods: In this study, sleep disturbance was examined among 89 patients initially presenting with anxiety or depressive disorders who provided follow-up at 12- and 30-year time points in the Nottingham Study of Neurotic Disorder. Multilevel models were used to identify factors most predictive of changes in sleep quality over time.

Results: There were strong associations between poor sleep and contemporaneous severity of personality disorder and the presence of other mental disorders at 12 and 30 years follow-up, but not with disorder presence at other time points. Improvements in personality disorder were associated with improvements in sleep between time points and attenuated the positive unadjusted effects of recovery from anxiety or depressive disorders to non-significance. Relapse into further episodes of mental disorder predicted poorer sleep, whereas worsening personality disorder was not predictive of significant changes when adjusting for other factors.

Conclusions: This study demonstrates the complex interplay between anxiety, depressive, and personality disorders and sleep disturbance over a long follow-up period. Future research might look to examine the relationship between personality disorder and disturbed sleep with interventional studies and by integrating personality trait research.

Objectives: Technology has the potential to increase access to evidence-based insomnia treatment. Patient preferences/perceptions of automated digital cognitive behavior therapy for insomnia (CBTI) and telehealth-delivered CBTI remain largely unexplored among middle-aged and older adults. Using a qualitative approach, the current study describes patients' reasons for participating in the clinical trial, preferences for digital CBTI (dCBTI) versus therapist-led CBTI, patient attitudes toward dCBTI, and patient attitudes toward telehealth-delivered therapist-led CBTI.

Method: Middle-aged and older adults (N = 80) completed a semi-structured interview before CBTI exposure. Qualitative responses were coded, and themes were inductively extracted.

Results: Most (62.5%) of the participants expressed a preference for therapist-led CBTI to dCBTI. Convenience was the most commonly reported advantage of dCBTI (n = 55) and telehealth-delivered CBTI (n = 65). Decreasing transit time and pandemic-related health concerns were identified as advantages to dCBTI and telehealth-delivered CBTI. Lack of human connection and limited personalization were perceived as disadvantages of dCBTI. Only three participants reported technological barriers to dCBTI and telehealth-delivered CBTI.

Conclusion: Findings suggest that, despite an overall preference for therapist-led treatment, most middle-aged and older adults are open to dCBTI. As both dCBTI and telehealth-delivered CBTI are perceived as convenient, these modalities offer the potential to increase access to insomnia care.

Objective: The management of HIV has shifted from a focus solely on the disease to a broader perspective encompassing co-occurring medical conditions and quality of life. Mental health concerns such as depression and sleep disturbances, particularly insomnia, are often overlooked in HIV care. The aim of the study was to investigate the longitudinal impact of insomnia on depression and medication adherence among (PLWH).

Methods: This study, conducted in an urban HIV clinic, involved active patients and assessed depression, insomnia, and medication adherence at baseline, 3-month, and 6-month intervals. Hierarchical linear models were employed to analyze the fixed and random effects of time, within-person and between-person insomnia on depression, as well as the effects of time, within-person and between-person depression on ART adherence.

Results: Within-person effects revealed that each one unit increase in the Insomnia Severity Index (ISI) was associated with a b = 0.267-point rise in Patient Health Questionnaire-9 (PHQ-9) scores (p < .001). Between-person effects revealed that each one-point increase in an individual's average ISI score was associated with a 0.476-point elevation in their PHQ-9 scores (p < .001). The between-person effects of depression on medication adherence indicated significance, with each point increase in an individual's average PHQ-9 score being linked to a 0.36% decrease in adherence (p = .012).

Conclusion: The study underscores the potential impact of insomnia on mental health and treatment adherence in people living with HIV (PLWH). This study emphasizes the necessity of comprehensive care models considering the interplay between sleep quality, mental health, and medication adherence for PLWH.

Objectives: This study aimed to validate the Korean version of the sleep hygiene practice scale (SHPS-K) and determine its effectiveness in screening poor sleepers with insomnia.

Methods: Online survey was conducted using translated SHPS in Korean, the Korean versions of the Pittsburgh Sleep Quality Index (PSQI-K), Insomnia Severity Index (ISI-K), and Epworth Sleepiness Scale (KESS) in a non-clinical population. The internal consistency and test-retest reliability of the SHPS-K were assessed using Cronbach's alpha and intraclass correlation coefficients (ICC), respectively. Construct validity was evaluated using correlation analyses with other questionnaires and confirmatory factor analysis. We determined the cutoff values that could identify poor sleepers with insomnia symptoms (PSQI-K > 5 and ISI-K ≥ 15) using receiver operating characteristic analysis.

Results: A total of 484 participants (242 women, mean age of 43.8 years) were enrolled. The average SHPS-K score was 71.2, with no significant sex differences. Women had poorer sleep scheduling and timing behaviors, and men had poorer eating and drinking behaviors. Good internal consistency (Cronbach's alpha = 0.88) and test-retest reliability (ICC = 0.80) were observed. The SHPS-K was positively correlated with the PSQI-K (r = 0.55), ISI-K (r = 0.54), and KESS (r = 0.42). A cutoff value of 73 identified poor sleepers with insomnia (area under the curve = 0.828).

Conclusions: The SHPS-K is a reliable instrument for evaluating sleep hygiene in non-clinical Korean populations.