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Feasibility and Acceptability of Mindfulness-based Stress Reduction and Prenatal Sleep Classes for Poor Prenatal Sleep Quality: Pilot Randomized Controlled Trial. 正念减压和产前睡眠课治疗产前睡眠质量差的可行性和可接受性:试点随机对照试验。
IF 2.2 3区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-09-01 Epub Date: 2024-06-07 DOI: 10.1080/15402002.2024.2359415
J N Felder, R Mirchandaney, R Manber, J Cuneo, A Krystal, N Solomon, S Janette, L Zhang, P Moran, M Mashash, E Epel, F M Hecht

Objectives: The main objectives of the current paper were to examine the feasibility, acceptability, and adherence of a remotely delivered intervention consisting of mindfulness-based stress reduction plus prenatal sleep classes (MBSR+PS) compared with treatment as usual (TAU).

Method: In this pilot randomized controlled trial, 52 pregnant women with poor sleep quality were randomized to MBSR+PS or TAU. MBSR was delivered through eight weekly 2.5-hour sessions, and PS was delivered through eight weekly 30-minute sessions. PS content drew material from cognitive behavioral therapy for insomnia tailored for the perinatal period and from a mindfulness- and acceptance-based lens. Participants completed endpoint measures 10-12 weeks after randomization.

Results: We surpassed all acceptability targets, including the percentage of eligible participants willing to be randomized (96%), percentage of participants who initiated treatment (88%), and satisfaction scores (Client Satisfaction Questionnaire-8 score M = 28.04, SD = 3.6). We surpassed all feasibility targets, including our enrollment target, retention rate (92%), and measure completion (96%). Finally, we surpassed adherence targets, including MBSR and PS session attendance (≥80%). Though sleep outcomes were exploratory, increases in sleep efficiency were greater in the MBSR+PS group relative to TAU (SMD=.68).

Conclusions: Patient-reported poor sleep quality during pregnancy has high public health significance because it is common, consequential, and under-treated. The current feasibility and acceptability data for using remotely delivered MBSR and PS to improve prenatal sleep quality are encouraging and warranting future research that is sufficiently powered and designed to provide efficacy data. In addition, exploratory sleep outcomes offer preliminary evidence that this sleep program may improve sleep efficiency during pregnancy.

目的:本文的主要目的是研究由正念减压和产前睡眠课程(MBSR+PS)组成的远程干预与常规治疗(TAU)相比的可行性、可接受性和依从性:在这项随机对照试验中,52 名睡眠质量不佳的孕妇被随机分配到 MBSR+PS 或 TAU。MBSR每周进行八次,每次2.5小时;PS每周进行八次,每次30分钟。PS 内容取材于针对围产期失眠症的认知行为疗法,并以正念和接受为基础。参与者在随机分配后 10-12 周完成终点测量:我们超越了所有可接受性目标,包括愿意接受随机化的合格参与者比例(96%)、开始治疗的参与者比例(88%)和满意度评分(客户满意度问卷-8 评分 M = 28.04,SD = 3.6)。我们超越了所有可行性目标,包括注册目标、保留率(92%)和测量完成率(96%)。最后,我们超越了坚持目标,包括 MBSR 和 PS 课程的出勤率(≥80%)。虽然睡眠结果是探索性的,但相对于 TAU,MBSR+PS 组的睡眠效率提高幅度更大(SMD=.68):患者报告的孕期睡眠质量差具有很高的公共卫生意义,因为它很常见、后果严重且治疗不足。目前,使用远程提供的 MBSR 和 PS 改善产前睡眠质量的可行性和可接受性数据令人鼓舞,值得在未来进行充分的研究,以提供疗效数据。此外,探索性睡眠结果提供了初步证据,证明该睡眠计划可提高孕期睡眠效率。
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引用次数: 0
Maternal Sleep Quality and Executive Function are Associated with Perceptions of Infant Sleep. 母亲的睡眠质量和执行功能与对婴儿睡眠的看法有关。
IF 2.2 3区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-09-01 Epub Date: 2024-05-15 DOI: 10.1080/15402002.2024.2355473
Samantha M Brown, Courtney M Donovan, Ariel A Williamson

Objectives: This study examined the associations among maternal sleep quality, executive function, and perceptions of infant sleep in a sample of families recruited from human service and public health systems.

Methods: Seventy-three mothers of infants 5-14 months old were included in the study. Mothers racially and ethnically identified as American Indian/Alaskan Native (4.1%), Asian (4.1%), Black/African American (12.3%), Latina (23.3%), more than one race (12.3%), Pacific Islander (1.4%), and White (42.5%). Mothers completed questionnaires assessing their own sleep (Pittsburgh Sleep Quality Index) and executive function (Behavior Rating Inventory of Executive Function) as well as their perceptions about their infant's sleep (Brief Infant Sleep Questionnaire).

Results: Results of the path analysis indicated significant direct effects among maternal sleep quality, executive function, and perceptions of infant sleep. Significant indirect effects were found such that poor maternal sleep quality was linked to poorer perceptions of infant sleep through maternal executive dysfunction, adjusting for infant sleep patterns, infant age, and maternal race and ethnicity.

Conclusions: The current study highlights the potential role of maternal behavioral and cognitive factors in shaping mothers' perceptions about infant sleep. These findings support the need for health professionals and researchers to consider maternal sleep quality and executive function when addressing mothers' concerns about infant sleep.

研究目的本研究对从人类服务和公共卫生系统招募的家庭样本中的母亲睡眠质量、执行功能和婴儿睡眠感知之间的关联进行了研究:本研究共纳入了 73 位 5-14 个月大婴儿的母亲。母亲的种族和人种分别为美国印第安人/阿拉斯加原住民(4.1%)、亚洲人(4.1%)、黑人/非洲裔美国人(12.3%)、拉丁裔(23.3%)、多个种族(12.3%)、太平洋岛民(1.4%)和白人(42.5%)。母亲们填写了评估自身睡眠(匹兹堡睡眠质量指数)和执行功能(执行功能行为评级量表)的问卷,以及她们对婴儿睡眠的看法(婴儿睡眠简明问卷):路径分析结果表明,母亲睡眠质量、执行功能和对婴儿睡眠的看法之间存在明显的直接影响。在对婴儿睡眠模式、婴儿年龄以及母亲的种族和民族进行调整后,发现了明显的间接效应,即母亲睡眠质量差与通过母亲执行功能障碍对婴儿睡眠的感知较差有关:当前的研究强调了母亲的行为和认知因素在影响母亲对婴儿睡眠的看法方面的潜在作用。这些研究结果表明,保健专业人员和研究人员在解决母亲对婴儿睡眠的担忧时,需要考虑母亲的睡眠质量和执行功能。
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引用次数: 0
Construction and Initial Examination of Inter-Rater Reliability of a Structured Clinical Interview for DSM-5-TR Sleep Disorders (SCISD) - Kid. DSM-5-TR睡眠障碍结构化临床访谈(SCISD)的构建及评分者间可靠性的初步检验 - Kid。
IF 2.2 3区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-09-01 Epub Date: 2024-03-08 DOI: 10.1080/15402002.2024.2324035
Mollie E Rischard, Tara R Buck, Kristi E Pruiksma, Aviva Johns, Lisa D Cromer

Study objectives: To construct and evaluate the inter-rater reliability of the Structured Clinical Interview for DSM-5-TR Sleep Disorders - Kid (SCISD-Kid).

Method: The SCISD-Kid was modeled on the adult SCISD-R and accounted for pediatric developmental and sociocultural factors. Fifty sleep-disturbed children (Mage = 11.9, SD = 2.9) and 50 caregivers responded to the final SCISD-Kid. Video recordings were double-scored to evaluate inter-rater reliability.

Results: The final SCISD-Kid contained approximately 90 questions. Eight of the nine covered disorders had prevalence rates sufficient for analyses for both samples (i.e., k > 2). Inter-rater reliability was examined using Cohen kappa coefficients (κ); reliability estimates ranged from excellent to good. For youth, restless legs syndrome yielded the lowest reliability (.48), while nightmare disorder, narcolepsy, and NREM sleep arousal disorder - sleepwalking type showed the highest reliability (1.00). Across caregivers, NREM sleep arousal disorder - sleep terror type (.49) and hypersomnolence (.54) had the lowest reliability. In contrast, circadian rhythm - delayed sleep phase type, nightmare disorder, and NREM sleep arousal disorder - sleepwalking type showed the highest reliability (1.00).

Conclusions: The SCISD-Kid is a promising tool for screening sleep disorders. It showed good to excellent reliability across both samples. Next steps for validation will be discussed.

研究目的构建并评估DSM-5-TR睡眠障碍结构化临床访谈-儿童(SCISD-Kid)的评分者间可靠性:方法:SCISD-Kid以成人SCISD-R为模型,并考虑了儿童发育和社会文化因素。50名睡眠障碍儿童(平均年龄=11.9岁,标准差=2.9岁)和50名照顾者对最终的SCISD-Kid做出了回答。视频记录经过双重评分,以评估评分者之间的可靠性:最终的 SCISD-Kid 包含约 90 个问题。在涵盖的九种疾病中,有八种疾病的患病率足以对两个样本进行分析(即 k > 2)。使用科恩卡帕系数(κ)对评分者之间的可靠性进行了检验;可靠性估计值从优秀到良好不等。对于青少年来说,不宁腿综合征的可靠性最低(0.48),而噩梦障碍、嗜睡症和 NREM 睡眠唤醒障碍--梦游型的可靠性最高(1.00)。在所有护理人员中,NREM 睡眠唤醒障碍--睡眠恐怖型(0.49)和嗜睡症(0.54)的可靠性最低。相比之下,昼夜节律--睡眠阶段延迟型、噩梦障碍和 NREM 睡眠唤醒障碍--梦游型的可靠性最高(1.00):SCISD-Kid 是一种很有前途的睡眠障碍筛查工具。结论:SCISD-Kid 是一种很有前途的睡眠障碍筛查工具,在两个样本中都表现出良好甚至极佳的可靠性。接下来将讨论验证的步骤。
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引用次数: 0
Perfect Enough to Sleep? Perfectionism and Actigraphy-Determined Markers of Insomnia. 完美到足以入睡?完美主义与行动测定法确定的失眠标记。
IF 2.2 3区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-09-01 Epub Date: 2024-05-24 DOI: 10.1080/15402002.2024.2355476
Susie Y Oh, Hailey Meaklim, Christian L Nicholas, David Cunnington, Maya Schenker, Cameron J Patrick, Daniel Windred, Lisa J Phillips

Objectives: Perfectionism is an important factor in insomnia development and maintenance. Previous studies exploring the relationship between perfectionism and insomnia have predominantly relied on self-reported sleep measures. Therefore, this study sought to assess whether actigraphy-measured sleep parameters were associated with perfectionism.

Methods: Sixty adults (85% females, mean age 30.18 ± 11.01 years) were sampled from the Australian general population. Actigraphy-derived objective sleep measures, subjective sleep diary measures, the Frost Multidimensional Perfectionism Scale (FMPS), Hewitt-Flett Multidimensional Perfectionism Scale (HFMPS) and Depression, Anxiety and Stress Scale 21 (DASS-21) were collected.

Results: High perfectionism levels were associated with poor sleep, but these relationships differed between objective and subjective measures. Perfectionism via FMPS total score and subscales of Concern over Mistakes, Doubts about Actions, Personal Standards and Self-oriented Perfectionism correlated with subjective sleep onset latency and sleep efficiency with moderate effects (r = .26 to .88). In contrast, perfectionism via HFMPS total score and subscales of Socially Prescribed Perfectionism and Parental Expectations predicted objective sleep onset latency and sleep efficiency. Additionally, stress mediated the relationships between objective sleep efficiency and Concern over Mistakes and Doubts about Actions.

Conclusions: Perfectionism demonstrated stronger associations with subjective than objective sleep measures. Higher Parental Expectations and Socially Prescribed Perfectionism may increase one's vulnerability to objectively measured poor sleep. Therefore, perfectionism may be important in preventing and treating insomnia.

目的:完美主义是导致失眠发生和维持的一个重要因素。以往探讨完美主义与失眠之间关系的研究主要依赖于自我报告的睡眠指标。因此,本研究试图评估动图测量的睡眠参数是否与完美主义有关:从澳大利亚普通人群中抽取了 60 名成年人(85% 为女性,平均年龄为 30.18 ± 11.01 岁)。结果:高完美主义水平与睡眠质量差有关:结果:高完美主义水平与睡眠质量差有关,但这些关系在客观和主观测量中有所不同。通过 FMPS 总分和 "对错误的担忧"、"对行动的怀疑"、"个人标准 "和 "以自我为导向的完美主义 "等分量表得出的完美主义与主观睡眠开始潜伏期和睡眠效率相关,影响程度适中(r = .26 至 .88)。与此相反,完美主义通过 HFMPS 总分以及社会规定完美主义和父母期望的子量表预测客观睡眠开始潜伏期和睡眠效率。此外,压力对客观睡眠效率与对错误的担忧和对行动的怀疑之间的关系具有中介作用:结论:完美主义与主观睡眠指标的关系比客观睡眠指标更密切。父母的较高期望和社会规定的完美主义可能会增加一个人客观测量睡眠不佳的脆弱性。因此,完美主义在预防和治疗失眠症方面可能很重要。
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引用次数: 0
Insomnia Symptoms and Menstrual Health: Is There a Link in Women During Reproductive Phase of Life? 失眠症状与月经健康:生殖期妇女的失眠症状与月经健康有关吗?
IF 2.2 3区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-09-01 Epub Date: 2024-05-31 DOI: 10.1080/15402002.2024.2361793
Isabela A Ishikura, Allan Saj Porcacchia, Helena Hachul, Sergio Tufik, Monica L Andersen

Objectives: To investigate the association between insomnia severity symptoms and menstrual health, fatigue and anxiety symptoms in women at reproductive age.

Method: We used data from EPISONO (2007), an epidemiological study from the city of São Paulo, Brazil. Women completed the Insomnia Severity Index (ISI), the Chalder Fatigue Scale (CFS), and the Beck Anxiety Inventory (BAI) to obtain information about insomnia, fatigue, and anxiety symptoms. For menstrual health, we collected information using our Institutional Women's Questionnaire about menstrual flow and duration, the presence of pain during menstruation and menstrual cycle regularity. The statistical analysis was performed using ordinal logistic regression, considering p < .05.

Results: Of the 1,042 participants, only 282 women met the inclusion criteria to participate in this study. The mean age was 34.4 years (SD ± 8.36), and the body mass index (BMI) was 25.7 (SD ± 5.39). According to the model, a 1-unit higher CFS score increased the odds of having more insomnia symptoms in the ISI (OR = 1.170; 95% CI=[1.073; 1.279]; p < .001). In the same way, a 1-unit higher BAI score increased the chance of presenting insomnia symptoms, according to the ISI (OR = 1.072; 95% CI=[1.042; 1.104]; p < .001). The menstrual variables did not represent statistical significance in the model.

Conclusions: Fatigue and anxiety symptoms were associated with insomnia symptoms; however, no association was observed between menstrual health and insomnia. The need to examine sleep when there are sleep complaints is essential to provide an accurate diagnosis that facilitates appropriate treatment and to provide better sleep quality for women.

目的:研究育龄妇女失眠严重程度症状与月经健康、疲劳和焦虑症状之间的关系:调查育龄妇女失眠严重症状与月经健康、疲劳和焦虑症状之间的关系:我们使用了巴西圣保罗市一项流行病学研究 EPISONO(2007 年)的数据。妇女们填写了失眠严重程度指数(ISI)、查尔德疲劳量表(CFS)和贝克焦虑量表(BAI),以获得有关失眠、疲劳和焦虑症状的信息。在月经健康方面,我们使用机构妇女问卷收集了有关月经量和持续时间、月经期间是否痛经以及月经周期是否规律的信息。统计分析采用了序数逻辑回归法,并考虑了 p 结果:在 1 042 名参与者中,只有 282 名妇女符合本研究的纳入标准。平均年龄为 34.4 岁(标准差 ± 8.36),体重指数(BMI)为 25.7(标准差 ± 5.39)。根据模型,CFS 分数每增加 1 个单位,在 ISI 中出现更多失眠症状的几率就会增加(OR = 1.170; 95% CI=[1.073; 1.279]; p p 结论:疲劳和焦虑症状与失眠症状有关,但月经健康与失眠之间没有关联。当出现睡眠主诉时,有必要对睡眠进行检查,以提供准确的诊断,促进适当的治疗,并为女性提供更好的睡眠质量。
{"title":"Insomnia Symptoms and Menstrual Health: Is There a Link in Women During Reproductive Phase of Life?","authors":"Isabela A Ishikura, Allan Saj Porcacchia, Helena Hachul, Sergio Tufik, Monica L Andersen","doi":"10.1080/15402002.2024.2361793","DOIUrl":"10.1080/15402002.2024.2361793","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the association between insomnia severity symptoms and menstrual health, fatigue and anxiety symptoms in women at reproductive age.</p><p><strong>Method: </strong>We used data from EPISONO (2007), an epidemiological study from the city of São Paulo, Brazil. Women completed the Insomnia Severity Index (ISI), the Chalder Fatigue Scale (CFS), and the Beck Anxiety Inventory (BAI) to obtain information about insomnia, fatigue, and anxiety symptoms. For menstrual health, we collected information using our Institutional Women's Questionnaire about menstrual flow and duration, the presence of pain during menstruation and menstrual cycle regularity. The statistical analysis was performed using ordinal logistic regression, considering <i>p</i> < .05.</p><p><strong>Results: </strong>Of the 1,042 participants, only 282 women met the inclusion criteria to participate in this study. The mean age was 34.4 years (SD ± 8.36), and the body mass index (BMI) was 25.7 (SD ± 5.39). According to the model, a 1-unit higher CFS score increased the odds of having more insomnia symptoms in the ISI (OR = 1.170; 95% CI=[1.073; 1.279]; <i>p</i> < .001). In the same way, a 1-unit higher BAI score increased the chance of presenting insomnia symptoms, according to the ISI (OR = 1.072; 95% CI=[1.042; 1.104]; <i>p</i> < .001). The menstrual variables did not represent statistical significance in the model.</p><p><strong>Conclusions: </strong>Fatigue and anxiety symptoms were associated with insomnia symptoms; however, no association was observed between menstrual health and insomnia. The need to examine sleep when there are sleep complaints is essential to provide an accurate diagnosis that facilitates appropriate treatment and to provide better sleep quality for women.</p>","PeriodicalId":55393,"journal":{"name":"Behavioral Sleep Medicine","volume":" ","pages":"770-778"},"PeriodicalIF":2.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141181413","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
Advancing Patient-Centered Care: An International Survey of Adolescent Perspectives on Insomnia. 推进以患者为中心的护理:青少年失眠观点国际调查》。
IF 2.2 3区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-09-01 Epub Date: 2024-03-15 DOI: 10.1080/15402002.2024.2322519
Sarah M Honaker, Stacey L Simon, Kelly C Byars, Danielle M Simmons, Ariel A Williamson, Lisa J Meltzer

Objective: The study objective was to inform patient-centered care for adolescent insomnia by describing adolescents' perspectives on insomnia. Specific constructs of interest included: 1) factors that contributed to insomnia development or maintenance, 2) impact of insomnia on day-to-day life, 3) recommended research priorities, and 4) overall experience living with insomnia.

Method: A convenience sample of adolescents (ages 13-18 years) self-identifying with insomnia symptoms was recruited through social media. Respondents (n = 3,014) completed an online survey. Responses to an open-ended item assessing patient experience were coded using thematic analysis.

Results: Participants identified as 70.8% White non-Hispanic, 77.0% female, and lived in one of five English-speaking countries (United States, United Kingdom, Canada, Australia, or New Zealand). Most (87.5%) met DSM-V diagnostic criteria for insomnia. The most common contributory factors to insomnia endorsed were stress (72.1%) and depressed mood (63.6%), while common impact areas were mood (72.2%), focus (61.0%), and pain (49.7%). Patient-centered research priorities were identifying insomnia causes (66.4%) and early detection (66.1%). Common adolescent experiences included high distress levels, feelings of invalidation, and helplessness about their insomnia.

Conclusions: Adolescents with insomnia offer a unique perspective that should inform patient-centered research and care. There is a need for heightened screening and awareness about insomnia as a condition that causes significant distress and impairment for adolescents. To provide validating care, providers should recognize the multifaceted causes of insomnia.

研究目的研究目的是通过描述青少年对失眠的看法,为青少年失眠症患者提供以患者为中心的护理。具体的研究内容包括1)导致失眠发生或维持的因素;2)失眠对日常生活的影响;3)建议的研究重点;4)失眠患者的总体生活体验:方法:通过社交媒体对自我认同有失眠症状的青少年(13-18 岁)进行抽样调查。受访者(n = 3,014)完成了一项在线调查。采用主题分析法对评估患者体验的开放式项目的回复进行了编码:参与者中 70.8% 为非西班牙裔白人,77.0% 为女性,居住在五个英语国家之一(美国、英国、加拿大、澳大利亚或新西兰)。大多数人(87.5%)符合 DSM-V 的失眠诊断标准。最常见的失眠诱因是压力(72.1%)和抑郁情绪(63.6%),常见的影响因素是情绪(72.2%)、注意力(61.0%)和疼痛(49.7%)。以患者为中心的研究重点是确定失眠原因(66.4%)和早期发现(66.1%)。青少年的共同经历包括高度痛苦、失效感以及对失眠的无助感:青少年失眠症患者提供了一个独特的视角,应该为以患者为中心的研究和护理提供参考。需要加强对失眠症的筛查,并提高对失眠症的认识,因为失眠症会给青少年带来严重的困扰和损害。为了提供有效的护理,医疗服务提供者应认识到导致失眠的多方面原因。
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引用次数: 0
Habitual Sleep Duration and Health-Related Quality of Life in Family Caregivers: Findings from the Behavioral Risk Factor Surveillance System. 家庭照顾者的习惯性睡眠时间和与健康相关的生活质量:行为风险因素监测系统的研究结果。
IF 3.1 3区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-07-01 Epub Date: 2024-02-09 DOI: 10.1080/15402002.2024.2314284
Everlyne G Ogugu, Maura R Reilly, Kougang T Anne Mbe, Janice F Bell

Background: Insufficient sleep duration is associated with poor health-related quality of life (HRQoL). However, this relationship has not been studied in family caregivers, a group at high risk of insufficient sleep duration and poor HRQoL.

Objective: To examine the associations between habitual sleep duration and HRQoL measures in family caregivers.

Methods: This cross-sectional study used data from 23,321 caregivers in the 2016 Behavioral Risk Factor Surveillance System. The HRQoL measures were health status and poor mental and physical health days. A multivariable logistic regression model was used to assess the association between sleep duration (<7, 7-9, >9 hours) and health status (fair or poor versus good to excellent). Zero-inflated negative binomial models were used to analyze the association of sleep duration with poor mental and physical health days.

Results: Fair or poor health status was significantly higher in caregivers with short (odds ratio [OR], 1.40; 95% CI: 1.12, 1.74) and long (OR, 2.07; 95% CI: 1.34, 3.21) sleep duration. Short sleep duration was associated with a higher number of poor mental health days (IRR [incident rate ratio], 1.17; 95% CI: 1.04, 1.31) and poor physical health days (IRR, 1.26; 95% CI: 1.10, 1.45). Long sleep duration was associated with more poor mental health days (IRR, 1.31; 95% CI: 1.08, 1.60).

Conclusion: Extremes in sleep duration were associated with lower HRQoL. These findings point to the need for interventions that promote adequate sleep and address factors underlying extremes in sleep duration in the context of family caregiving.

背景:睡眠时间不足与健康相关生活质量(HRQoL)低下有关。然而,这种关系尚未在家庭照顾者中进行研究,而家庭照顾者是睡眠时间不足和 HRQoL 低下的高风险群体:目的:研究家庭照顾者的习惯性睡眠时间与 HRQoL 测量之间的关系:这项横断面研究使用了 2016 年行为风险因素监测系统中 23321 名照顾者的数据。HRQoL测量指标为健康状况和身心健康不良天数。多变量逻辑回归模型用于评估睡眠时间(9小时)与健康状况(一般或差与好到优)之间的关联。零膨胀负二项模型用于分析睡眠时间与精神和身体健康不良天数之间的关系:睡眠时间短(几率比 [OR],1.40;95% CI:1.12,1.74)和睡眠时间长(OR,2.07;95% CI:1.34,3.21)的护理人员的健康状况一般或较差。睡眠时间短与精神健康状况较差的天数(IRR[事故率比],1.17;95% CI:1.04,1.31)和身体健康状况较差的天数(IRR,1.26;95% CI:1.10,1.45)相关。结论:睡眠时间过长与更多的心理健康不良日有关(IRR,1.31;95% CI:1.08,1.60):结论:睡眠时间过长与较低的 HRQoL 有关。这些研究结果表明,有必要采取干预措施,促进充足的睡眠,并解决家庭护理中睡眠时间过长的根本原因。
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引用次数: 0
A prospective study of nightmare disorder among Chinese adults in Hong Kong: Persistence and mental health outcomes. 香港华裔成年人梦魇症前瞻性研究:持续性和心理健康结果。
IF 2.2 3区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-07-01 Epub Date: 2024-02-18 DOI: 10.1080/15402002.2024.2318264
Stanley Kam Ki Lam, Cherry Tin Yan Cheung, Edward K S Wang, Albe Sin Ying Ng, Hong Wang Fung

Objectives: Previous studies showed that nightmares are prevalent and are associated with negative health outcomes. However, no empirical data is available demonstrating the extent to which nightmare disorder persists over time. Current literature provides a limited understanding of the trajectory and wider mental health outcomes of nightmare disorder. This longitudinal study examined the persistence and mental health outcomes of nightmare disorder.

Methods: A total of 230 Hong Kong Chinese adults completed standardized assessments twice with an interval of about 6 months.

Results: Over half (66.7%) of the participants with probable nightmare disorder at baseline remained to meet the DSM-5 criteria for the disorder at follow-up. Participants with probable nightmare disorder at baseline were significantly more likely to screen positive for PTSD (82.1% vs 18.3%) (p < .001) (p < .001), and they reported higher rates of mental health service usage at both timepoints (p = .001 to .003). Baseline nightmare disorder severity was negatively associated with subsequent self-rated mental health (β = -.151, p = .010) and self-esteem (β = -.141, p = .009) and it also predicted subsequent PTSD symptoms (β = .122, p = .012).

Conclusions: This study provides first empirical data showing that nightmare disorder could be persistent over time. Nightmare disorder symptoms are associated not only with PTSD symptoms but also with a broader range of mental health issues. This study points to the public health importance of identifying and managing nightmare disorder symptoms in the community. Additionally, the presence of nightmare disorder symptoms may be a helpful indicator for identifying post-traumatic stress.

研究目的以往的研究表明,噩梦是一种普遍现象,并与不良的健康后果相关。然而,目前还没有实证数据表明噩梦障碍会在多大程度上长期存在。目前的文献对噩梦障碍的发展轨迹和更广泛的心理健康影响的了解十分有限。这项纵向研究探讨了噩梦障碍的持续性和对心理健康的影响:结果:超过半数(66.7%)的梦魇障碍患者在梦魇障碍的持续时间内会出现精神障碍:超过半数(66.7%)在基线时患有疑似噩梦障碍的参与者在随访时仍符合DSM-5的噩梦障碍标准。基线时患有疑似噩梦障碍的参与者在创伤后应激障碍筛查中呈阳性的几率明显更高(82.1% vs 18.3%)(p p = .001 to .003)。基线噩梦障碍严重程度与随后的自评心理健康(β = -.151,p = .010)和自尊(β = -.141,p = .009)呈负相关,它还预测了随后的创伤后应激障碍症状(β = .122,p = .012):本研究首次提供了实证数据,表明噩梦障碍可能会长期存在。噩梦障碍症状不仅与创伤后应激障碍症状有关,还与更广泛的心理健康问题有关。这项研究指出了在社区中识别和管理噩梦障碍症状的公共卫生重要性。此外,噩梦障碍症状的存在可能是识别创伤后应激障碍的一个有用指标。
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引用次数: 0
Factors Influencing Adherence to Insomnia and Obstructive Sleep Apnea Treatments among Veterans with Mild Traumatic Brain Injury. 影响轻度脑外伤退伍军人坚持失眠和阻塞性睡眠呼吸暂停治疗的因素。
IF 2.2 3区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-07-01 Epub Date: 2024-02-29 DOI: 10.1080/15402002.2024.2322517
Adam R Kinney, Lisa A Brenner, Morgan Nance, Joseph Mignogna, Audrey D Cobb, Jeri E Forster, Christi S Ulmer, Risa Nakase-Richardson, Nazanin H Bahraini

Objective: To understand factors influencing adherence to recommended treatment for insomnia and obstructive sleep apnea (OSA) among Veterans with mild traumatic brain injury (mTBI).

Method: Semi-structured interviews (n = 49) with 29 clinical stakeholders and 20 Veterans were conducted. Clinical stakeholders included Veterans Health Administration providers and policymakers involved in the management of mTBI and/or sleep disorders. Veterans included those with a clinician-confirmed mTBI with a recent history of insomnia disorder and/or OSA treatment. Themes were identified using a Descriptive and Interpretive approach.

Results: Barriers to sleep disorder treatment adherence included factors associated with the patient (e.g., negative appraisal of treatment benefit), intervention (e.g., side effects), health conditions (e.g., cognitive challenges), health care system (e.g., limited availability of care), and socioeconomic status (e.g., economic instability). Similarly, facilitators of adherence included patient- (e.g., positive appraisal of treatment benefit), intervention- (e.g., flexible delivery format), condition- (e.g., accommodating cognitive impairments), health care system- (e.g., access to adherence support), and socioeconomic-related factors (e.g., social support).

Conclusions: Interviews revealed the multi-faceted nature of factors influencing adherence to sleep disorder treatment among Veterans with mTBI. Findings can inform the development of novel interventions and care delivery models that meet the complex needs of this population.

目的了解影响轻度脑外伤(mTBI)退伍军人坚持建议的失眠和阻塞性睡眠呼吸暂停(OSA)治疗的因素:对 29 名临床利益相关者和 20 名退伍军人进行了半结构式访谈(n = 49)。临床利益相关者包括退伍军人健康管理局的医疗服务提供者以及参与轻微创伤性脑损伤和/或睡眠障碍管理的政策制定者。退伍军人包括那些经临床医生确认患有 mTBI 且近期有失眠症和/或 OSA 治疗史的退伍军人。研究采用描述性和解释性方法确定主题:坚持睡眠障碍治疗的障碍包括与患者(如对治疗效果的负面评价)、干预(如副作用)、健康状况(如认知障碍)、医疗系统(如医疗服务有限)和社会经济地位(如经济不稳定)相关的因素。同样,促进坚持治疗的因素包括患者因素(如对治疗益处的积极评价)、干预因素(如灵活的治疗形式)、病情因素(如适应认知障碍)、医疗系统因素(如获得坚持治疗的支持)以及社会经济相关因素(如社会支持):访谈显示,影响患有 mTBI 的退伍军人坚持睡眠障碍治疗的因素是多方面的。研究结果可为开发新型干预措施和护理服务模式提供信息,以满足这一人群的复杂需求。
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引用次数: 0
Sleep-specific outcomes attributable to digitally delivered cognitive behavioral therapy for insomnia in adults with insomnia and depressive symptoms. 数字化交付的认知行为疗法对患有失眠和抑郁症状的成年人失眠的睡眠特异性结果
IF 2.2 3区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-07-01 Epub Date: 2023-11-28 DOI: 10.1080/15402002.2023.2285799
Philip J Batterham, Frances P Thorndike, Robert Gerwien, Jeffrey Botbyl, Lee M Ritterband, Yuri Maricich, Helen Christensen

Objective: Randomized controlled trials (RCTs) of digitally delivered Cognitive Behavioral Therapy for insomnia (CBT-I) have demonstrated reductions in insomnia severity, depression symptoms, anxiety symptoms, and suicidal ideation. The present study aimed to evaluate the effectiveness of self-guided, digital CBT-I to improve sleep-specific outcomes.

Method: An RCT of Australian adults with insomnia and depressive symptoms (N = 1149) compared SHUTi, a digital CBT-I intervention, with HealthWatch, an attention-matched control internet program, at baseline, posttest (9 weeks) and at 6-, 12-, and 18-month follow-ups. Online sleep diaries were used to derive measures of sleep-onset latency (SOL), wake after sleep onset (WASO), sleep efficiency (SE), number of awakenings, sleep quality, and total sleep time (TST).

Results: Participants in the SHUTi condition had greater improvements at posttest compared with control for: SOL, WASO, SE, number of awakenings, and sleep quality. These improvements were sustained at every follow-up (p < .02 for all outcomes except TST, in which statistically significant increases were observed only at 12- and 18-months).

Conclusions: Digitally delivered CBT-I produced lasting improvements in sleep outcomes among adults with insomnia and depressive symptoms. Findings provide further evidence of long-term improvements associated with a digital therapeutic for insomnia, compared to an attention-control condition.

目的:数字化认知行为疗法治疗失眠(CBT-I)的随机对照试验(rct)已经证明失眠严重程度、抑郁症状、焦虑症状和自杀意念的降低。本研究旨在评估自我引导的数字CBT-I在改善睡眠特定结果方面的有效性。方法:一项澳大利亚成年人失眠和抑郁症状的随机对照试验(N = 1149)比较了数字CBT-I干预方法SHUTi与注意力匹配控制网络程序HealthWatch在基线、测试后(9周)以及6、12和18个月的随访。在线睡眠日记用于获得睡眠开始潜伏期(SOL)、睡眠开始后醒来(WASO)、睡眠效率(SE)、醒来次数、睡眠质量和总睡眠时间(TST)的测量。结果:与对照组相比,舒提组受试者在SOL、WASO、SE、觉醒次数和睡眠质量方面有更大的改善。结论:数字化交付的CBT-I对失眠和抑郁症状的成年人的睡眠结果产生了持久的改善。研究结果提供了进一步的证据,证明与注意力控制条件相比,数字治疗与失眠的长期改善有关。
{"title":"Sleep-specific outcomes attributable to digitally delivered cognitive behavioral therapy for insomnia in adults with insomnia and depressive symptoms.","authors":"Philip J Batterham, Frances P Thorndike, Robert Gerwien, Jeffrey Botbyl, Lee M Ritterband, Yuri Maricich, Helen Christensen","doi":"10.1080/15402002.2023.2285799","DOIUrl":"10.1080/15402002.2023.2285799","url":null,"abstract":"<p><strong>Objective: </strong>Randomized controlled trials (RCTs) of digitally delivered Cognitive Behavioral Therapy for insomnia (CBT-I) have demonstrated reductions in insomnia severity, depression symptoms, anxiety symptoms, and suicidal ideation. The present study aimed to evaluate the effectiveness of self-guided, digital CBT-I to improve sleep-specific outcomes.</p><p><strong>Method: </strong>An RCT of Australian adults with insomnia and depressive symptoms (<i>N</i> = 1149) compared SHUTi, a digital CBT-I intervention, with HealthWatch, an attention-matched control internet program, at baseline, posttest (9 weeks) and at 6-, 12-, and 18-month follow-ups. Online sleep diaries were used to derive measures of sleep-onset latency (SOL), wake after sleep onset (WASO), sleep efficiency (SE), number of awakenings, sleep quality, and total sleep time (TST).</p><p><strong>Results: </strong>Participants in the SHUTi condition had greater improvements at posttest compared with control for: SOL, WASO, SE, number of awakenings, and sleep quality. These improvements were sustained at every follow-up (<i>p</i> < .02 for all outcomes except TST, in which statistically significant increases were observed only at 12- and 18-months).</p><p><strong>Conclusions: </strong>Digitally delivered CBT-I produced lasting improvements in sleep outcomes among adults with insomnia and depressive symptoms. Findings provide further evidence of long-term improvements associated with a digital therapeutic for insomnia, compared to an attention-control condition.</p>","PeriodicalId":55393,"journal":{"name":"Behavioral Sleep Medicine","volume":" ","pages":"410-419"},"PeriodicalIF":2.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138453139","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
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Behavioral Sleep Medicine
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