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Project Sandman: A Quasi-Experimental Evaluation of a Group-Based Brief Sleep Intervention in Air Force Technical Training. 睡魔项目:对空军技术培训中以小组为基础的简短睡眠干预的准实验评估。
IF 2.2 3区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-11-01 Epub Date: 2024-07-31 DOI: 10.1080/15402002.2024.2386606
J M Ellis, R A Estevez Burns, I Mallawaarachchi, X-Q Wang, C A Aycock, A E Krunnfusz, J R Jones, J A Blue Star, M A Patience, D G Cassidy, D J Taylor, R C Klesges, G W Talcott

Objectives: Approximately 70% of the military personnel experience chronic sleep insufficiency, which negatively impacts military readiness and health. Military sleep health does not appear to be improving despite targeted programs to optimize sleep. The present quasi-experimental study aims to evaluate a single-session sleep intervention in United States Air Force (USAF) Technical Training.

Method: A group-based Brief Sleep Intervention (BSI) was developed for the target population. Participants included 321 technical school students (Mean age = 21; 82% male; 67% White) who were assigned to the BSI (n = 203) or a control group (n = 118). Propensity-score-weighted multivariable logistic regression was employed to compare outcomes.

Results: At the 2-week follow-up, students in the BSI were significantly more likely to report sleeping 6 or more hours on weekdays (OR = 1.49, p < .001) and "Good/Very Good" sleep quality (OR = 1.50, p = .032) than those in the control group. In addition, 69.2% of the students in BSI reported having engaged in the self-selected "Action Step" chosen during the intervention.

Conclusions: To our knowledge, this is the first study to test a preventative sleep intervention in USAF Technical Training. Results suggest that a single-session group intervention can promote behavioral changes and improve sleep health.

目标:约有 70% 的军人长期睡眠不足,这对军事准备和健康产生了负面影响。尽管开展了有针对性的计划来优化睡眠,但军人的睡眠健康状况似乎并没有得到改善。本准实验研究旨在对美国空军(USAF)技术培训中的单次睡眠干预进行评估:方法:针对目标人群开发了基于小组的简短睡眠干预(BSI)。参与者包括 321 名技校学生(平均年龄 = 21 岁;82% 为男性;67% 为白人),他们被分配到 BSI 组(n = 203)或对照组(n = 118)。采用倾向分数加权多变量逻辑回归法对结果进行比较:在两周的随访中,BSI 组学生报告工作日睡眠时间达到或超过 6 小时的可能性明显高于对照组(OR = 1.49,P = .032)。此外,69.2%的学生表示在干预期间参与了自选的 "行动步骤":据我们所知,这是第一项在美国空军技术培训中测试预防性睡眠干预的研究。结果表明,单节课的小组干预可以促进行为改变并改善睡眠健康。
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引用次数: 0
Melatonin Use in School-Aged Children and Adolescents: An Exploration of Caregiver and Pharmacist Perspectives. 学龄儿童和青少年使用褪黑素的情况:对护理人员和药剂师观点的探讨。
IF 2.2 3区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-11-01 Epub Date: 2024-09-15 DOI: 10.1080/15402002.2024.2396838
Samantha K M Lee, Kingston W C M Yeung, Yu Sun Bin, Lorraine Smith, Edwin C K Tan, Rose Cairns, Janet M Y Cheung

Objective: This study aims to explore the perspectives and experiences of Australian caregivers and community pharmacists about pediatric melatonin use.

Methods: A convenience sample of caregivers with children (aged 11-16 years) using melatonin as a sleep aid and community pharmacists (including pharmacist interns) were recruited. Participants first completed an online survey followed by an online semi-structured interview. Interviews were guided by a schedule of questions for the respective participant groups, broadly exploring their beliefs about melatonin, experiences in using/supplying melatonin, and perceived facilitators/barriers for melatonin use. Interviews were digitally recorded, transcribed verbatim, and analyzed using the Framework Approach.

Results: Fourteen caregivers of predominantly neurodiverse adolescents and 24 community pharmacists were interviewed. While melatonin was perceived by caregivers of both typically developing and neurodiverse dependants as safer than pharmacological sleep aids, treatment was only initiated after trialling non-pharmacological strategies first. Pharmacists expressed concerns around the ambiguities in practice and the limited scope of existing resources for guiding pediatric melatonin use. Caregivers frequently deferred to the information available online to procure products or self-adjust doses and dosing schedules. Both pharmacists and caregivers emphasized the need for more affordable and age-appropriate proprietary formulations that are readily accessible.

Conclusion: Melatonin is administered predominantly by caregivers of neurodiverse adolescents to address their sleep disturbances. The findings underscore the need for reliable, evidence-based information to guide safe and appropriate use of melatonin in pediatric populations. Patient education is also warranted to address maladaptive medication-administration practices. Lastly, there is a need for stronger regulatory oversight of melatonin products to ensure their quality and safety of use.

研究目的本研究旨在探讨澳大利亚护理人员和社区药剂师对儿童使用褪黑素的看法和经验:方法:研究人员对使用褪黑素辅助睡眠的儿童(11-16 岁)护理人员和社区药剂师(包括实习药剂师)进行了抽样调查。参与者首先完成一份在线调查,然后进行在线半结构化访谈。访谈以针对各参与群体的问题表为指导,广泛探讨他们对褪黑素的看法、使用/供应褪黑素的经验以及使用褪黑素的促进因素/障碍。对访谈进行数字录音、逐字记录,并采用框架方法进行分析:共采访了 14 名主要是神经多样化青少年的照顾者和 24 名社区药剂师。虽然典型发育依赖者和神经多样化依赖者的照护者都认为褪黑素比药物助眠剂更安全,但只有在先试用了非药物策略后才开始治疗。药剂师对实践中的模糊性以及指导儿科褪黑素使用的现有资源范围有限表示担忧。护理人员经常依赖网上的信息来购买产品或自行调整剂量和用药计划。药剂师和护理人员都强调,需要价格更低廉、适合不同年龄段、易于获取的专利配方:结论:褪黑素主要由照顾神经多样化青少年的护理人员使用,以解决他们的睡眠障碍问题。研究结果表明,有必要提供可靠的循证信息,以指导儿科人群安全、适当地使用褪黑素。此外,还需要开展患者教育,以解决用药不当的问题。最后,有必要加强对褪黑素产品的监管,以确保其质量和使用安全。
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引用次数: 0
Does format matter? A naturalistic study of digital and provider-led cognitive behavioral therapy for insomnia implemented in a healthcare system. 形式重要吗?在医疗保健系统中实施数字和医疗服务提供者主导的失眠认知行为疗法的自然研究。
IF 2.2 3区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-11-01 Epub Date: 2024-08-14 DOI: 10.1080/15402002.2024.2385822
Alexandra C Reed, Daniel G Rogers, Gregory S Berlin, Laura Burrone, Greg Dante, Jason DeViva, Elissa McCarthy, Maria E Niculete, Gia Santoro, Eric D A Hermes

Objectives: Cognitive Behavioral Therapy for Insomnia (CBTi) is a first-line treatment for a prevalent and impairing disorder. Digital CBTi programs increase access to internet-based self-directed care. However, the clinical effect of offering different forms of CBTi in a healthcare setting is not clearly understood. This study examines treatment engagement and clinical outcomes for individuals referred to either digital or provider-led CBTi.

Methods: Over two years, providers at a Veterans Health Administration (VHA) facility referred patients to digital CBTi with telephone coaching support or traditional provider-led CBTi. Characteristics of those referred, proportions engaging in and completing treatment, as well as insomnia severity were compared among those referred to each format.

Results: Providers referred 139 individuals to digital CBTi, 340 to provider-led CBTi, and 14 to both formats. Individuals referred to digital CBTi were older with less severe insomnia. Despite lower levels of program engagement and completion in the digital CBTi cohort, measures of insomnia symptom change were similar between the groups.

Conclusions: This is the first study to evaluate both digital and provider-led evidence-based treatments for insomnia disorder simultaneously deployed in a healthcare setting. While engagement in digital CBTi lagged that for provider-led CBTi, offering both formats may expand access to different groups, while fostering similar outcomes.

目标:失眠认知行为疗法(CBTi)是治疗普遍存在的失眠症的一线疗法。数字 CBTi 项目增加了基于互联网的自主治疗的可及性。然而,在医疗机构中提供不同形式的 CBTi 的临床效果尚不清楚。本研究考察了转诊至数字 CBTi 或由提供者主导的 CBTi 的患者的治疗参与度和临床效果:在两年的时间里,退伍军人健康管理局(VHA)的医疗机构将患者转介给有电话辅导支持的数字化 CBTi 或传统的由医疗机构主导的 CBTi。对转诊患者的特征、参与和完成治疗的比例以及失眠严重程度进行了比较:结果:医疗服务提供者向 139 人推荐了数字 CBTi,向 340 人推荐了医疗服务提供者主导的 CBTi,向 14 人推荐了两种形式。转介到数字化 CBTi 的患者年龄较大,失眠症较轻。尽管数字 CBTi 群体的项目参与度和完成度较低,但两组失眠症状变化的测量结果相似:这是第一项在医疗机构中同时评估失眠症数字疗法和由医疗服务提供者主导的循证疗法的研究。虽然数字化 CBTi 的参与度落后于医疗服务提供者主导的 CBTi,但提供这两种形式可能会扩大不同群体的参与度,同时产生相似的结果。
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引用次数: 0
Improving Sleep in People with HIV and Chronic Pain: A Pilot Study of Brief Behavioral Treatment for Insomnia. 改善艾滋病病毒感染者和慢性疼痛患者的睡眠:失眠症简短行为治疗试点研究。
IF 2.2 3区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-11-01 Epub Date: 2024-09-08 DOI: 10.1080/15402002.2024.2396820
Shameka L Cody, Daniel A Kusko, Cesar E Gonzalez, Michael A Owens, Joanna M Hobson, Shannon R Gilstrap, Stephen J Thomas, Burel R Goodin

Objectives: Insomnia and chronic pain are common symptoms in people with HIV. Poor sleep has been associated with chronic pain. While cognitive behavioral therapy for insomnia improves insomnia in clinical populations, there are barriers to people with HIV accessing treatment including the lack of trained providers and lengthy sessions. Only one study has examined the efficacy of brief behavioral treatment for insomnia (BBTI) in people with HIV. This study examined BBTI effects on sleep and pain in people with HIV.

Methods: Ten adults with HIV and chronic pain completed a 4-week, telephone-delivered BBTI treatment. A control group (n = 10) completed a brief mindfulness training (BMT). The Insomnia Severity Index and Brief Pain Inventory were used to assess insomnia severity and pain outcomes, respectively.

Results: There was a significant interaction between intervention and time on insomnia severity, F (2,14) = 5.7, p = .02, partial η2 = 0.45). The BBTI group demonstrated significant improvements in insomnia severity from pre- to post-intervention (p < .001) and from pre-intervention to one-month post-intervention (p = .001) compared to the BMT group. There was a significant interaction between intervention and time on pain interference, F (1,18) = 4.9, p = .02, partial η2 = 0.27). The BBTI group demonstrated a significant decrease in pain interference from pre- to post-intervention (p < .001) compared to the BMT group.

Conclusions: This pilot study demonstrated that BBTI improved insomnia in people with HIV for up to one-month post-treatment. Novel preliminary evidence suggests that BBTI may also improve pain outcomes in people with HIV.

目的:失眠和慢性疼痛是艾滋病毒感染者的常见症状。睡眠质量差与慢性疼痛有关。虽然失眠认知行为疗法能改善临床人群的失眠状况,但艾滋病病毒感染者在接受治疗时仍面临一些障碍,包括缺乏训练有素的提供者和疗程过长。只有一项研究考察了失眠简短行为疗法(BBTI)对艾滋病病毒感染者的疗效。本研究考察了 BBTI 对 HIV 感染者睡眠和疼痛的影响:方法:10 名患有艾滋病和慢性疼痛的成人完成了为期 4 周的电话指导 BBTI 治疗。对照组(n = 10)完成了简短的正念训练(BMT)。失眠严重程度指数和简易疼痛量表分别用于评估失眠严重程度和疼痛结果:干预和时间对失眠严重程度有明显的交互作用,F (2,14) = 5.7, p = .02, partial η2 = 0.45)。与 BMT 组相比,BBTI 组的失眠严重程度从干预前到干预后都有明显改善(p p = .001)。干预和时间对疼痛干扰有明显的交互作用,F (1,18) = 4.9, p = .02, partial η2 = 0.27)。从干预前到干预后,BBTI 组的疼痛干扰明显减少(p 结论:BBTI 组的疼痛干扰明显减少:这项试点研究表明,BBTI 可在治疗后一个月内改善 HIV 感染者的失眠状况。新的初步证据表明,BBTI 也可以改善 HIV 感染者的疼痛症状。
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引用次数: 0
Behavioral interventions and behavior change techniques used to improve sleep outcomes in athlete populations: A scoping review. 用于改善运动员睡眠质量的行为干预和行为改变技术:范围综述。
IF 2.2 3区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-11-01 Epub Date: 2024-07-04 DOI: 10.1080/15402002.2024.2374257
Sandy M B Wilson, Katherine V Sparks, Alice Cline, Stephen B Draper, Martin I Jones, John K Parker

Background: Athletes display a high prevalence of undesired sleep characteristics that may affect both performance and wellbeing.

Objectives: This scoping review aimed to identify and map the existing evidence of behavioral sleep interventions and their effects on sleep outcomes in athletes, and retrospectively code the behavior change techniques (BCTs) implemented using the Behavior Change Technique Taxonomy (BCTTv1).

Methods: Conducted following the JBI methodology for scoping reviews, four online databases were used to identify prospective interventions with at least one behavioral component in competitive athletes, and reporting a sleep outcome pre- and post-intervention.

Results: Thirty-three studies met the inclusion criteria, encompassing 892 participants with a median age of 23. Five intervention categories were identified (education, mind-body practices, direct, multi-component, and other), with each demonstrating mixed efficacy but the potential to improve sleep outcomes. The BCTs varied in type and frequency between each category, with only 18 unique BCTs identified across all studies.

Conclusions: The varied efficacy of previous studies at improving sleep outcomes may be attributed to the lack of behavior change theory applied during intervention development. Designing interventions following a targeted specification of the behavioral problem, and the integration of corresponding BCTs should be considered in future research.

背景:运动员普遍存在不良睡眠特征,这可能会影响他们的表现和健康:本范围综述旨在确定和绘制现有的行为睡眠干预证据及其对运动员睡眠结果的影响,并使用行为改变技术分类标准(BCTTv1)对已实施的行为改变技术(BCT)进行回顾性编码:方法:按照 JBI 的范围综述方法,使用四个在线数据库来确定对竞技运动员进行的至少包含一种行为成分的前瞻性干预,并报告干预前后的睡眠结果:有 33 项研究符合纳入标准,涉及 892 名参与者,中位年龄为 23 岁。研究确定了五个干预类别(教育、身心练习、直接干预、多成分干预和其他干预),每个类别的干预效果不一,但都有可能改善睡眠结果。每类干预措施的类型和频率各不相同,在所有研究中只发现了18种独特的干预措施:结论:以往的研究在改善睡眠结果方面效果不一,这可能是由于在制定干预措施时缺乏行为改变理论。在未来的研究中,应考虑在设计干预措施时,有针对性地明确行为问题,并结合相应的行为改变理论。
{"title":"Behavioral interventions and behavior change techniques used to improve sleep outcomes in athlete populations: A scoping review.","authors":"Sandy M B Wilson, Katherine V Sparks, Alice Cline, Stephen B Draper, Martin I Jones, John K Parker","doi":"10.1080/15402002.2024.2374257","DOIUrl":"10.1080/15402002.2024.2374257","url":null,"abstract":"<p><strong>Background: </strong>Athletes display a high prevalence of undesired sleep characteristics that may affect both performance and wellbeing.</p><p><strong>Objectives: </strong>This scoping review aimed to identify and map the existing evidence of behavioral sleep interventions and their effects on sleep outcomes in athletes, and retrospectively code the behavior change techniques (BCTs) implemented using the Behavior Change Technique Taxonomy (BCTTv1).</p><p><strong>Methods: </strong>Conducted following the JBI methodology for scoping reviews, four online databases were used to identify prospective interventions with at least one behavioral component in competitive athletes, and reporting a sleep outcome pre- and post-intervention.</p><p><strong>Results: </strong>Thirty-three studies met the inclusion criteria, encompassing 892 participants with a median age of 23. Five intervention categories were identified (education, mind-body practices, direct, multi-component, and other), with each demonstrating mixed efficacy but the potential to improve sleep outcomes. The BCTs varied in type and frequency between each category, with only 18 unique BCTs identified across all studies.</p><p><strong>Conclusions: </strong>The varied efficacy of previous studies at improving sleep outcomes may be attributed to the lack of behavior change theory applied during intervention development. Designing interventions following a targeted specification of the behavioral problem, and the integration of corresponding BCTs should be considered in future research.</p>","PeriodicalId":55393,"journal":{"name":"Behavioral Sleep Medicine","volume":" ","pages":"820-842"},"PeriodicalIF":2.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141536068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Conceptual overlap of negative thought processes in insomnia: A focus on catastrophizing, worry, and rumination in a student sample. 失眠症中消极思维过程的概念重叠:关注学生样本中的灾难化、担忧和反刍。
IF 2.2 3区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-11-01 Epub Date: 2024-07-01 DOI: 10.1080/15402002.2024.2374264
Markus Jansson-Fröjmark, Rikard Sunnhed, Colleen E Carney, Ingvar Rosendahl

Objectives: The association and overlap between different forms of negative thought processes in insomnia is largely unknown. The purpose of the current investigation was to examine conceptual overlap between three insomnia-specific negative thought processes; catastrophizing, worry, and rumination, identify the underlying factors, and explore their associations with insomnia symptoms.

Methods: A total of 360 students completed three insomnia-related negative thought process scales (Catastrophic Thoughts about Insomnia Scale, Anxiety and Preoccupation about Sleep Questionnaire, Daytime Insomnia Symptom Response Scale) and two insomnia symptoms measures (the Insomnia Severity Index and Sleep Condition Indicator).

Results: The three scales and their subscales displayed acceptable reliabilities. Further, confirmatory factor analysis was supportive of the notion of catastrophizing, worry, and rumination measures as distinct. The catastrophizing and worry constructs were significantly associated with insomnia symptoms, but the rumination factor was not.

Conclusions: The findings indicate that catastrophizing, worry, and rumination might be viewed as distinct constructs. Although more research is warranted on the topic of conceptual overlap, the current results might have implications for the development of models of insomnia, clinical research, and practice.

目的:失眠症中不同形式的消极思维过程之间的关联和重叠在很大程度上是未知的。本次调查的目的是研究三种失眠特异性消极思维过程(灾难化、担忧和反刍)之间的概念重叠,确定其潜在因素,并探讨它们与失眠症状的关联:共有360名学生完成了三个与失眠相关的消极思维过程量表(关于失眠的灾难性想法量表、关于睡眠的焦虑和惴惴不安问卷、白天失眠症状反应量表)和两个失眠症状量表(失眠严重程度指数和睡眠状况指标):结果:三个量表及其子量表的信度均可接受。此外,确认性因子分析支持灾难化、担忧和反刍测量是不同的概念。灾难化和担忧因子与失眠症状显著相关,但反刍因子与失眠症状无关:结论:研究结果表明,灾难化、担忧和反刍可被视为不同的结构。结论:研究结果表明,灾难化、担忧和反刍可能被视为不同的构念,尽管在概念重叠的问题上还需要进行更多的研究,但目前的研究结果可能对失眠症模型的开发、临床研究和实践产生影响。
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引用次数: 0
Adapting and Evaluating the Feasibility and Acceptability of a Behavioral Intervention to Promote Sleep Health in Cardiac Rehabilitation. 调整和评估行为干预的可行性和可接受性,以促进心脏康复中的睡眠健康。
IF 2.2 3区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-11-01 Epub Date: 2024-08-09 DOI: 10.1080/15402002.2024.2386602
Caitlan A Tighe, Angela Phares, Debra K Weiner, Gregory P Beehler, Jessie VanSwearingen, Allison G Harvey, Michelle M Hilgeman, Daniel J Buysse, Daniel E Forman

Objectives: Study objectives were to: 1) iteratively adapt the Transdiagnostic Sleep and Circadian Intervention (TranS-C) for patients in cardiac rehabilitation (CR; Phase 1) and 2) conduct a preliminary single group pre-post intervention test to a) evaluate procedural feasibility and intervention acceptability and b) to explore preliminary pre-post changes in self-reported sleep, disability, and health-related quality of life (HRQoL; Phase 2).

Method: In Phase 1, 12 individuals in CR and six content experts completed interviews to inform TranS-C adaptations. Interviews were analyzed using rapid qualitative analysis. In Phase 2, eight individuals in CR completed a baseline assessment, the adapted TranS-C intervention, and a post-intervention assessment. Intervention acceptability was assessed via questionnaire and interview. Sleep, disability, and HRQoL outcomes were assessed using questionnaires. Descriptive statistics were calculated for quantitative measures; interviews were analyzed using rapid qualitative analysis.

Results: Phase 1 participants were receptive to the premise and structure of the adapted intervention. In Phase 2, participants endorsed positive attitudes toward the intervention. Seven of eight participants demonstrated improvements in sleep outcomes. Disability and HRQoL results did not consistently improve.

Conclusion: The adapted TranS-C intervention was acceptable to CR patients and could yield improvements in subjective sleep outcomes. Larger-scale testing in CR is warranted.

研究目标研究目标是1)针对心脏康复(CR)患者反复调整跨诊断睡眠和昼夜节律干预(TranS-C);2)进行初步的单组事后干预测试,以 a) 评估程序的可行性和干预的可接受性;b) 探索自我报告的睡眠、残疾和健康相关生活质量(HRQoL)在事后的初步变化;第 2 阶段:在第 1 阶段,12 名 CR 患者和 6 名内容专家完成了访谈,为 TranS-C 的调整提供信息。访谈采用快速定性分析法进行分析。在第 2 阶段,8 名 CR 患者完成了基线评估、经调整的 TranS-C 干预和干预后评估。干预的可接受性通过问卷和访谈进行评估。睡眠、残疾和 HRQoL 结果通过问卷进行评估。定量指标采用描述性统计;访谈采用快速定性分析:结果:第一阶段的参与者接受了调整后干预的前提和结构。在第二阶段,参与者对干预持积极态度。8 名参与者中有 7 人的睡眠状况有所改善。残疾和 HRQoL 结果没有持续改善:结论:经调整的 TranS-C 干预方案可为 CR 患者接受,并能改善主观睡眠结果。有必要在 CR 中进行更大规模的测试。
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引用次数: 0
Quality of Sleep and Its Determinants Among People with Diabetes Mellitus in Sub-Saharan Africa: A Systematic Review and Meta-Analysis. 撒哈拉以南非洲糖尿病患者的睡眠质量及其决定因素:系统回顾与元分析》。
IF 2.2 3区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-11-01 Epub Date: 2024-06-15 DOI: 10.1080/15402002.2024.2367469
Setegn Fentahun, Techilo Tinsae, Gidey Rtbey, Fantahun Andualem, Mulualem Kelebie, Getasew Kibralew, Girum Nakie, Samuel Teferi, Asnake Tadesse, Mamaru Melkam, Gebresilassie Tadesse

Background: Poor sleep quality is a serious concern among diabetes mellitus patients, adversely affecting glycemic management and the prognosis of diabetic patients. Therefore, the main aim of this study was to estimate the overall pooled prevalence of poor sleep quality and its associated factors among diabetic patients in Sub-Saharan Africa.

Methods: Several search databases were employed to retrieve the eligible studies. A standardized data extraction format was used to extract the data, and the analysis was conducted using STATA version 14. To determine heterogeneity, the I2 test was conducted, and both the funnel plot and Egger's regression test were used to assess the publication bias. A random effects model meta-analysis was performed to estimate the overall prevalence and associated factors of poor sleep quality.

Results: In the current meta-analysis, a total of 11 studies with 3,766 study participants were included. The overall pooled prevalence of poor sleep quality among diabetic patients was 53.22% (95% CI: 36.26, 70.19). Poor sleep quality was significantly associated with longer duration of diabetes (OR = 2.94, 95% CI: 1.85, 4.67), poor glycemic control (OR = 2.24, 95% CI: 1.51, 3.32), depression (OR = 4.09, 95% CI: 2.07, 8.05) and comorbidity (OR = 1.94, 95% CI: 1.31, 2.88).

Conclusion: In this study, more than half of diabetic patients in Sub-Saharan Africa had poor sleep quality. Therefore, healthcare providers should give more attention to sleep disorders when screening diabetic patients to improve their poor sleep quality.

背景:睡眠质量差是糖尿病患者严重关切的问题,会对血糖管理和糖尿病患者的预后产生不利影响。因此,本研究的主要目的是估算撒哈拉以南非洲地区糖尿病患者睡眠质量差及其相关因素的总体患病率:方法:利用多个搜索数据库检索符合条件的研究。采用标准化数据提取格式提取数据,并使用 STATA 14 版本进行分析。为确定异质性,进行了 I2 检验,并使用漏斗图和 Egger 回归检验来评估发表偏倚。随机效应模型荟萃分析估计了睡眠质量差的总体患病率和相关因素:在本次荟萃分析中,共纳入了 11 项研究和 3,766 名参与者。糖尿病患者睡眠质量差的总体患病率为 53.22%(95% CI:36.26, 70.19)。睡眠质量差与糖尿病病程长(OR = 2.94,95% CI:1.85,4.67)、血糖控制不佳(OR = 2.24,95% CI:1.51,3.32)、抑郁(OR = 4.09,95% CI:2.07,8.05)和合并症(OR = 1.94,95% CI:1.31,2.88)明显相关:在这项研究中,撒哈拉以南非洲地区一半以上的糖尿病患者睡眠质量较差。因此,医护人员在筛查糖尿病患者时应更多地关注睡眠障碍,以改善他们的不良睡眠质量。
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引用次数: 0
Cognitive behavior therapy for insomnia in university students delivered via videoconferencing groups: A pilot study. 通过视频会议小组为大学生提供失眠认知行为疗法:试点研究。
IF 2.2 3区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-11-01 Epub Date: 2024-07-01 DOI: 10.1080/15402002.2024.2374258
Michelle Tadros, Sophie Li, Britt Corkish, Emily Upton, Jill Newby, Aliza Werner-Seidler

Introduction: Sleep difficulties are common amongst university students and are associated with mental illness and reduced wellbeing. This paper reports a pilot study of Cognitive Behavior Therapy for Insomnia (CBT-I) tailored specifically for university students. It was hypothesized that the intervention would be feasible, acceptable, and improve sleep, anxiety, depression, and wellbeing.

Method: Students aged 18-25 participated via videoconferencing small group sessions of CBT-I. Feasibility was assessed through sign-up, consent rates, and study attrition, while acceptability was assessed using intervention adherence and a measure of intervention acceptability. Outcome measures included sleep quality, insomnia, suicidal ideation, symptoms of depression, anxiety, and wellbeing, and were assessed at baseline and post-intervention.

Results: Participants were 44 students (M = 21.8 years). Feasibility was confirmed by sign-up and consent rates (80% of the students who expressed interest agreed to participate); overall study attrition was 48%, comprised largely of participants not commencing treatment (27%). Participants perceived the program as effective and logical and made use of the skills suggested. In terms of adherence, 82% of the participants who engaged with treatment attended two or more sessions and 63% attended all four sessions; and 92% were either very satisfied or mostly satisfied. Sleep quality, insomnia, depression, anxiety, and wellbeing all significantly improved from pre- to post-intervention.

Discussion: There was evidence that the CBT-I intervention tailored for university students was acceptable to participants and could be feasible to deliver. Sleep quality, depression, anxiety, and wellbeing improved significantly. These findings suggest that the intervention is suitable for evaluation in a fully powered randomized controlled trial.

简介睡眠困难在大学生中很常见,与精神疾病和健康状况下降有关。本文报告了一项专门针对大学生的失眠认知行为疗法(CBT-I)试点研究。研究假设该干预措施是可行的、可接受的,并能改善睡眠、焦虑、抑郁和幸福感:方法:18-25 岁的学生通过视频会议参加 CBT-I 的小组会议。可行性通过注册率、同意率和研究损耗进行评估,可接受性则通过干预坚持率和干预可接受性测量进行评估。结果测量包括睡眠质量、失眠、自杀意念、抑郁症状、焦虑和幸福感,并在基线和干预后进行评估:参与者为 44 名学生(男 = 21.8 岁)。报名率和同意率证实了该计划的可行性(80%表示有兴趣的学生同意参与);研究的总体流失率为48%,其中大部分是未开始治疗的参与者(27%)。参与者认为该计划有效、合理,并使用了所建议的技能。在坚持治疗方面,82%的参与者参加了两次或两次以上的治疗,63%的参与者参加了全部四次治疗;92%的参与者表示非常满意或基本满意。从干预前到干预后,睡眠质量、失眠、抑郁、焦虑和幸福感都有明显改善:讨论:有证据表明,为大学生量身定制的 CBT-I 干预方法是可以被参与者接受的,也是可行的。睡眠质量、抑郁、焦虑和幸福感都有明显改善。这些研究结果表明,该干预措施适合在完全有效的随机对照试验中进行评估。
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引用次数: 0
Trait-based Anxiety Symptoms are Associated with Higher Incidence of Nightmare Frequency in the Wisconsin Sleep Cohort. 基于特质的焦虑症状与威斯康星睡眠队列中较高的噩梦发生率有关。
IF 2.2 3区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-11-01 Epub Date: 2024-07-31 DOI: 10.1080/15402002.2024.2386608
Matthew K P Gratton, Nancy Hamilton, Diego R Mazzotti

Objectives: Nightmares affect up to 12% of the population and are often comorbid with psychiatric disorders like anxiety and depression. Limited research has examined their influence on nightmare frequency. This study investigates the relationship between depression and trait-anxiety symptoms on incident nightmare frequency at follow-up.

Method: Cross-sectional and longitudinal analyses were conducted on 758 Wisconsin Sleep Cohort participants. Trait anxiety and depression symptom severity were measured using the State Trait Anxiety Inventory and Zung Depression Scale. Ordinal regression determined nightmare frequency cutoffs based on anxiety and depression severity. Cross-sectional associations were assessed with Spearman and Kruskal-Wallis tests. Longitudinal associations were analyzed using adjusted binomial regression of binary nightmare frequency (low: <4/month, high: >5/month) against clinical cutoffs of trait anxiety and depression.

Results: Adjusted models indicated a small correlation between baseline nightmare frequency and trait anxiety (β = 0.01, p = .010) and depression symptoms (β = 0.01, p = .005). High baseline trait-anxiety symptoms were associated with frequent nightmares at follow-up (OR = 3.75, CI95% [1.306,10.793], p < .014), but depression symptoms were not (OR = 1.35, CI95%[0.399, 4.587], p = .627).

Conclusions: Our findings suggest that high trait-anxiety symptoms are associated with increased incident nightmare frequency, when adjusted for depression. However, high depression symptoms were not associated with an increase in nightmare frequency when adjusted for trait-anxiety.

目的:多达 12% 的人受到噩梦的影响,而且噩梦往往与焦虑症和抑郁症等精神疾病并发。有关它们对噩梦频率影响的研究十分有限。本研究调查了抑郁症状和特质焦虑症状在随访中对噩梦发生频率的影响:方法:对 758 名威斯康星睡眠队列参与者进行了横向和纵向分析。采用国家特质焦虑量表和 Zung 抑郁量表测量特质焦虑和抑郁症状的严重程度。根据焦虑和抑郁的严重程度,用正序回归法确定了噩梦频率临界值。横向联系采用 Spearman 和 Kruskal-Wallis 检验进行评估。使用二元噩梦频率(低:5/月)与特质焦虑和抑郁的临床临界值的调整二项式回归分析纵向关联:调整后的模型表明,基线噩梦频率与特质焦虑(β = 0.01,p = .010)和抑郁症状(β = 0.01,p = .005)之间存在微小的相关性。高基线特质焦虑症状与随访时经常做噩梦有关(OR = 3.75,CI95% [1.306,10.793],P = .627):我们的研究结果表明,在对抑郁症进行调整后,高特质焦虑症状与噩梦发生频率的增加有关。然而,在对特质焦虑进行调整后,高抑郁症状与噩梦频率的增加无关。
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Behavioral Sleep Medicine
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