Behavioral Sleep Medicine最新文献

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.

Background: Stroke sleep disorders have negative effects on physiological function, readmission rate and mortality. However, the effects on cognitive function were inconsistent. This study aims to identify the impact of sleep disorders on cognitive functions in stroke, and the relationship between types of sleep disorders and cognitive disorders.

Methods: This systematic review and meta-analysis searched PubMed, the Cochrane Library, Web of Science, Embase, Chinese Biomedical Database (CBM), CNKI, Wanfang and VIP Database from inception until October 13, 2024. Using Revman 5.3 software to combine the odds ratios (ORs) and standardized mean differences (SMDs) reported in the study separately. Quality assessment, heterogeneity, and sensitivity analyses were also involved.

Results: There were 6 longitudinal studies and 10 cross-sectional studies involving 5,779 patients. Longitudinal studies showed that stroke patients with sleep disorders were more likely to have cognitive impairment [OR = 2.35, 95% CI (1.67, 3.31), I² = 0%, p > .1]. Cross-sectional studies showed the same results [OR = 2.45, 95% CI (1.77, 3.40), I² = 65%, p < .1], and the results did not change much [OR = 2.62, 95% CI (2.15, 3.20), I² = 0%, p > .1] after the deletion of the literature that caused high heterogeneity. Age has a significant effect on cognition in stroke patients with sleep disorders (p < .1). Egger's test showed no significant publication bias (p > .1).

Conclusions: Sleep disorders are associated factors affecting cognitive impairment in stroke patients, and the older the age, the greater the negative effect.

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.

Objectives: The present study evaluated associations among sleep health, insomnia symptoms, and loneliness across the adult lifespan.

Methods: Adults ages 19-99 (N = 2297, M_age = 44 years) completed an online RU-SATED sleep health questionnaire, Insomnia Severity Index, and Gierveld Loneliness scale (measuring total, social and emotional loneliness). Direct associations among sleep health, insomnia symptoms, and loneliness were examined. Moderation analyses investigated whether associations between sleep health, insomnia symptoms, and loneliness differed by age.

Results: Better sleep health and younger age were associated with lower loneliness total and subscale scores. Greater insomnia symptoms and older age were associated with higher loneliness total and subscale scores (p's < .05). Age moderated associations between sleep health and total and emotional loneliness (b = 0.01, t = 2.63, p = .009; b = 0.04, t = 3.15, p = .002) and between insomnia symptoms and total and emotional loneliness scores (b = -0.002, t = -2.30, p = .02; b = -0.002, t = -2.88, p = .004), such that the associations were strongest in younger adults compared to other ages.

Conclusions: Younger adults may experience more benefits of better sleep health on loneliness compared to older adults. Insomnia symptoms were associated with loneliness across the lifespan but were less pronounced among older adults. It may be worth exploring how promoting sleep health might assist in reducing loneliness across the adult lifespan.

Objective: To examine the associations between parent perceived environmental factors, nighttime sleep duration and 24-h sleep duration among an international sample of preschool-aged children.

Methods: Secondary analyses of cross-sectional data from preschoolers across 23 countries (19 LMICs), collected during the third pilot phase (January 2021-August 2024) of the SUNRISE Study. Parents completed a questionnaire which asked about their child's sleep patterns and environmental factors that impacted their child's sleep in the previous 3 days.

Results: Data from 2,219 children were analyzed. A significant difference was observed between nighttime sleep (F = 14.27, p = <0.0001) and nap duration (F = 9.10, p = 0.0004) across country income level. Environmental factors such as heat (-12.87, 95% CI: -11.54, -0.61) and cold (-17.70, 95% CI: -34.53, -0.85) were negatively associated with nighttime sleep duration.

Conclusions: Public health researchers and professionals should prioritize context-specific strategies to minimize the impact of weather conditions on sleep to promote healthy levels of sleep among preschoolers from diverse settings.

Objective: Bedtime procrastination describes going to bed later than intended, leading to insufficient sleep. Although difficulty falling asleep and pre-sleep arousal are assumed to cause bedtime procrastination, the relationship has not been directly examined. In this study, we examined whether difficulty falling asleep and pre-sleep arousal lead to bedtime procrastination.

Methods: We conducted a longitudinal survey, administered three times at 1-month intervals, among participants aged 18-65 years; 1,102 participants were included in the final analysis. Participants were asked to complete questionnaires that included bedtime procrastination, difficulty falling asleep, and pre-sleep arousal (cognitive and somatic) measures. The random intercept cross-lagged panel model was used to test the hypothesis that difficulty falling asleep and pre-sleep arousal increased bedtime procrastination.

Results: No significant cross-lagged path was observed from difficulty falling asleep or pre-sleep cognitive arousal to bedtime procrastination. A significant positive path was observed from pre-sleep somatic arousal to bedtime procrastination between Times 2 and 3, but not Times 1 and 2.

Conclusion: Although difficulty falling asleep did not lead to bedtime procrastination, pre-sleep somatic arousal partially led to bedtime procrastination. These findings suggest that individuals with higher pre-sleep somatic arousal might develop more bedtime procrastination.

Objectives: Insomnia is highly comorbid with mental health conditions, yet graduate psychology students receive limited training in sleep and insomnia management. An online introductory sleep workshop focused on insomnia management with Cognitive Behavioral Therapy for Insomnia (CBT-I) was developed for Australian graduate psychology students to address this training gap. However, some students reported difficulties applying CBT-I knowledge to clinical practice. This study explored the barriers and facilitators to implementing CBT-I knowledge into graduate psychology students' practice post-workshop.

Methods: Semi-structured interviews were conducted with 15 graduate psychology students who attended an online introductory sleep and CBT-I workshop. Data were analyzed using reflexive thematic analysis.

Results: Facilitators of CBT-I implementation included: (1) Helpful workshop resources; (2) Increased awareness of the importance of sleep's role in mental health; (3) Enhanced self-efficacy with introductory sleep skills (e.g. sleep history taking); and (4) Knowing where to access further training. Barriers included: (1) Limited ongoing training and clinical supervision; (2) Accessibility challenges; (3) Clinical implementation challenges; and (4) Constraints of being a graduate student.

Conclusion: The introductory workshop facilitated the development of introductory CBT-I skills among graduate psychology students, but ongoing training and supervision are needed to enhance implementation and expand Australia's CBT-I workforce.

Objective: Research indicates a strong relationship between dietary inflammation and sleep; however, such research is limited among women postpartum. We studied whether prenatal and postnatal pro-inflammatory diets were associated with postpartum sleep quality and duration.

Methods: A secondary data analysis was conducted among 219 women from the Health in Pregnancy and Postpartum randomized controlled trial promoting healthy lifestyles in pregnant women with pre-pregnancy overweight and obesity. Data from ≤16 and 32 weeks gestation, and 6 and 12 months postpartum were used. Sleep was measured using BodyMedia's SenseWear® armband. Energy-adjusted Dietary Inflammatory Index (E-DII^TM) scores were calculated using micro and macronutrients intake collected from 24-hour dietary recalls. Linear mixed-effects models estimated the impact of the E-DII score on postpartum sleep parameters.

Results: Women consuming pro-inflammatory diets, compared to anti-inflammatory diets were more likely to have a later bedtime (p = .04) and a later waketime (p = .03). For every one-unit increase in the prenatal E-DII score, 6-months postpartum sleep latency increased by 0.57 minute (p = .03). Among those receiving the intervention, changes in E-DII scores led to a 7.3-minute earlier bedtime (p = .01), 5.2-minute longer sleep duration (p = .03) and additional 5.7-minute longer time-in-bed (p = .05) compared to controls.

Conclusions: Results suggest anti-inflammatory diets during pregnancy and postpartum may be beneficial for better sleep.