Behavioral Sleep Medicine最新文献

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.

Purpose: Poor sleep among adolescents is a significant public health concern. Delivering Cognitive Behavioral Therapy for insomnia (CBT-I) in schools may be an effective way to reach adolescents with poor sleep. This systematic review and meta-analysis examined the effectiveness of school-based CBT-I for improving sleep quality and/or duration among adolescents with insomnia symptoms or disorder.

Methods: A systematic search of studies between 2003 and 2025 was conducted in March 2025. Inclusion criteria were adolescents aged 10-19 years (population) with insomnia symptoms, school-based interventions using evidence-based CBT-I principles (intervention), randomized or non-randomized trials (comparator), and reported sleep quality and/or duration (outcome).

Results: Eight studies (n = 323; M age = 15.3 years; 62.57% female) from four countries were included. Meta-analysis of within sleep intervention condition groups (n = 8) found significant subjective improvements post-intervention: total sleep time (TST) increased by 23.87 minutes (p < .001), sleep onset latency (SOL) decreased by 8.34 minutes (p < .01), and sleep quality improved g = 0.376 (p = .001). Objective measures of TST increased by 20.91 minutes (p = 0.100), SOL decreased by 1.35 minutes (p = 0.202), and sleep efficiency rose by 0.50% (p = .792). Anxiety improved significantly g = 0.373 (p < .01), but depression did not g = 0.806 (p = .196).

Discussion: While sleep improvements were only observed for subjective sleep outcomes, this review suggests that school-based CBT-I may be an effective avenue to address adolescent insomnia. Given the limited evidence, we identify key methodological and implementation considerations to guide practice.

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.

Objectives: This study examined whether the interaction between chronotype and sleep duration moderates the relationship between smartphone usage time and problematic smartphone use (PSU) among early adolescents.

Methods: A cross-sectional secondary analysis was conducted using nationally representative data from the 2018 Korean Children and Youth Panel Survey (N = 3,919; 4th and 7th graders). Chronotype, sleep duration, smartphone use, and PSU were assessed. Moderation and moderated moderation analyses were conducted using PROCESS Macro models, controlling for personal, familial, school, and community covariates.

Results: This study demonstrated that chronotype and sleep duration interacted to moderate the association between smartphone use and problematic smartphone use (PSU) in early adolescents. Short sleep duration strengthened the positive association between smartphone use and PSU in both advanced and delayed chronotypes. By contrast, with longer sleep duration, this association shifted to a negative correlation, particularly in advanced chronotypes.

Conclusions: These findings suggest that both sleep duration and chronotype may play important roles in the association between smartphone use and PSU in early adolescence. Parental and school-based programs that encourage healthy sleep and smartphone use habits could be promising avenues for intervention. Longitudinal research is needed to further investigate the directionality and mechanisms of these associations.

Objective: The cultural and historical experiences of African American family caregivers increase their risk for poor sleep health. Limited research representation hinders the development of effective sleep interventions for their unique needs. The purpose of this study is to explore the barriers and facilitators to sleep health in African American family caregivers and describe participants' preferences and recommendations for sleep health interventions.

Method: Using a qualitative descriptive approach, African American family caregivers of community-dwelling adults with chronic or disabling conditions were recruited via community-based methods. Twenty-four caregivers participated in semi-structured in-person, telephone, or videoconference interviews. Transcribed interviews were analyzed using conventional content analysis.

Results: Participants were on average 58 years old, mostly female (87.5%), and caring for a parent (79.2%). Caregivers reported significant sleep health barriers due to caregiving responsibilities, various sources of stress, and personal health problems such as anxiety or sleep apnea. Caregiving responsibilities disrupted sleep due to irregular sleep timing, night time interruptions from care recipients' needs, and hypervigilance to ensure care recipient safety. Sleep facilitators included accessing caregiving resources such as self-initiated proactive strategies to address care recipient needs and caregiving support from other family members. Caregivers also described how daytime activities, relaxation strategies, and natural or prescribed sleep aids helped improve their sleep. Lastly, caregivers suggested topics for intervention sessions and shared their preferences for intervention delivery.

Conclusion: Our findings inform the cultural adaptation of sleep health interventions for African American family caregivers to address stress reduction, caregiving support, and sleep apnea risk and treatment.

Objective: Routine psychotherapy for mental health problems does not adequately address insomnia. Integrating cognitive behavior therapy for insomnia (CBTI) into routine psychotherapy could both extend the reach of CBTi and enhance sleep and mental health outcomes. Digital CBTi (dCBTI) is a promising and scalable option for integration that requires little prior training and session time. This study aimed to understand the perspectives of licensed mental health therapists on the acceptability and feasibility of this strategy of integrated dCBTI.

Method: Six one-hour focus groups were conducted with 52 licensed therapists (21 PhD/PsyD, 11 LCSW, 10 MFT, 9 LPC, 2 MD). Each group included 6-11 participants. Inductive thematic analysis was used.

Results: Therapists identified general advantages of dCBTI, benefits to integration, and concerns about integration. They described the knowledge and resources needed both for training and in session. They expressed that a 4-hour workshop and spending 5-10 minutes in session supporting patient use of dCBTI would be feasible.

Conclusion: Data offer preliminary evidence in support of the perceived value, acceptability, and feasibility of integrating dCBTI in routine psychotherapy from a therapist perspective. Therapists are open to receiving training in integrated dCBTI and see its potential value in improving outcomes for their patients.

Background: While prior research has shown that early life events can impact sleep during adulthood. However, the specific aspects of sleep affected in those who experienced abuse as a child and potential environmental factors that may help ameliorate these difficulties is less understood.

Objectives: The present cross-sectional study examined the relationship between abuse as a child and several key dimensions of poor sleep (sleep quality, insomnia symptoms and typical sleep duration). Additionally, perceived bedroom safety was examined as a potential moderator.

Participants and methods: A sample of 1,002 individuals completed measures of current sleep problems and perceived levels of safety in the bedroom. Additionally, participants indicated whether they had been exposed to physical or sexual abuse as a child. 204 participants reported being abused during childhood, defined as sexual or physical abuse.

Results: A series of linear regressions demonstrated - a) associations between a history of abuse as a child and adult poorer sleep quality, increased insomnia symptomology, and shorter sleep durations and b) these associations, in the main, were moderated by current perceived bedroom safety. Of those who had experienced abuse as a child, perceiving the bedroom as a safe environment was associated with a 52% reduction in perceived poor sleep quality, 19% reduction in insomnia symptoms and 37% increase in sleep duration compared to those who currently slept in an environment they perceived to be unsafe.

Conclusions: While childhood abuse is associated with worse sleep health, these self-reported results indicate that the adult perception of safe bedroom mitigates that association.

Objective: This study aimed to translate, validate, and adapt an Arabic version of the "Sleep Disturbances Scale for Children" (SDSC).

Materials and methods: The process involved translation, synthesis, supervision, and back-translation, followed by expert committee review and pretesting. Psychometric testing included an online questionnaire on socio-demographic characteristics, the Arabic and English versions of SDSC, launched online from June to August 2022. Cronbach's alpha coefficient, intraclass correlation coefficient (ICC), and Cohen's Kappa coefficient were measured to evaluate internal consistency, overall questionnaire reliability, and inter-judge reliability of each questionnaire item, respectively. An exploratory factor analysis (EFA) was then conducted to study construct validity.

Results: 409 respondents, predominantly mothers, participated in this study. The mean score of the average of the English and Arabic versions was 1.78 ± 0.61 and 1.66 ± 0.51, respectively. The Cronbach's alpha was estimated at 0.92 for the English version and 0.88 for the Arabic version. ICC showed good reliability and agreement between the two tests, which was 0.82. EFA allowed the extraction of 7 underlying factors in the questionnaire.

Conclusion: Our Arabic version of the SDSC is a reliable, valid, and adapted tool, allowing the assessment of sleep disorders in children in the Arab world.

Objective: To examine the mediating role of depressive symptoms in the relationship between internalized homophobia and sleep quality among sexual minority men (SMM), and test whether perceived social support moderates this pathway.

Methods: A cross-sectional survey was conducted among 563 Chinese SMM (age= 29.6 ± 8.1 years) in China. All participants completed measures of internalized homophobia, sleep quality, Depressive Symptoms, Perceived Social Support. Mediation and moderated mediation models were conducted using the SPSS PROCESS v3.5 macro.

Results: The research reported SMM with poorer sleep quality had a higher level of internalized homophobia and depressive symptoms. Depressive symptoms mediated the relationship between internalized homophobia and sleep quality. In addition, perceived social support moderated the relationship between depressive symptoms and sleep quality.

Conclusions: Understanding the pathways through which internalized homophobia impacts sleep quality is key to improving sleep health of SMM. Targeted interventions should reduce internalized homophobia while strengthening perceived social support to improve sleep health in this population.