Behavioral Sleep Medicine最新文献

Study objectives: This study aims to explore the perception of a WeChat-delivered cognitive behavioral therapy for insomnia (CBT-I) to manage insomnia in pregnant women in mainland, China.

Methods: A descriptive qualitative research design was used. Focus groups and individual interviews with semi-structured questions were conducted via a video conferencing platform with 29 Chinese pregnant women with insomnia symptoms during December 2023 to March 2024. Data were analyzed using content analysis.

Results: Three themes and 10 subthemes were identified: (1) Appreciating sleep intervention for pregnancy insomnia; (2) Suggestions for intervention contents; (3) Recommendations on the format of WeChat articles. Participants appreciated the intervention's focus on pregnancy insomnia, recognizing its potential to address previously overlooked challenges. Participants indicated a willingness to engage with the program, although they raised concerns about an excessive focus on sleep-related issues. Suggestions for content improvement included using clear and plain language, incorporating scientific explanations to reinforce credibility, combining generalized content with personalized insomnia solutions, and including information relevant to the perinatal period. Participants also emphasized the need for family involvement to support them in managing insomnia. Regarding the format of WeChat articles, participants highlighted form is secondary to content helpfulness, while many suggested using engaging titles and visuals. Additionally, some prefer the short-form videos delivered via short video platforms over WeChat-delivered methods.

Conclusions: WeChat for delivering CBT-I for reducing insomnia symptoms was well received by the Chinese pregnant women and the identified main features may facilitate the design for future intervention studies.

Introduction: Operational work contexts promote sleep and circadian disturbances, especially in extreme environments. To identify mitigation factors, this study aimed to explore submariners' sleep changes in relation to a mission and association with different psychological factors.

Methods: Thirty military submariners were evaluated in real-life conditions on three consecutive periods: pre-mission/baseline, submarine mission, post-mission/recovery. Sleep duration, quality, and sleepiness were collected continuously via diary and actigraphy. Personality traits, coping strategies, locus of control, fatigue, anxiety, and depressive symptoms were assessed through questionnaires.

Results: During the mission, there was a significant decrease in sleep duration and quality and increase in sleepiness compared with baseline, recovering post-mission. Submariners slept a median of 55 minutes less than before the mission and 91 minutes less than after the mission. They also rated their sleep quality 0.45 points lower, while reporting 1.85 points higher sleepiness at the beginning of work shifts. Higher work satisfaction and extraversion trait score correlated with better scores on subjective sleep variables during the mission. Higher neuroticism trait and avoidant coping style had a negative impact on sleep-related parameters in all periods, mediated by anxiety symptoms.

Conclusion: Psychological factors are relevant for sleep in extreme occupational settings, especially regarding subjective parameters, and even in highly selected and trained populations, potentially informing intervention opportunities.

Objective: Pregnancy, as a complex physiological process, significantly alters maternal sleep patterns, which are closely associated with various maternal health outcomes. This study explored the association between maternal sleep health and anxiety/depression symptoms and whether this association differed by family function.

Methods: A cross-sectional survey was conducted among pregnant women attending obstetrics departments at two hospitals in Nanjing, China. The Sleep Health Index, Family APGAR, and Patient Health Questionnaire-4 were administered to evaluate sleep health, family function, and anxiety and depression symptoms of pregnant women in late pregnancy, respectively. Multiple linear and logistic regressions were applied, with the moderation effect of the family function being assessed by adding interaction terms in the models.

Results: A total of 199 pregnant women in late pregnancy completed the survey. The average age and gestational age were 30.95 years (SD = 3.38, Range: 19-42) and 36.39 weeks (SD = 2.52, Range: 28-40), respectively. The scores of sleep health, anxiety, depression, and family function were 84.37 ± 10.61, 0.00 (0.00, 2.00), 0.00 (0.00, 1.00), and 8.79 ± 1.82, respectively. Results showed that better sleep health was associated with lower scores of anxiety (β=-0.03, p < .001) and depression (β=-0.04, p < .001) symptoms and lower odds of anxiety (adjusted odds ratio, aOR = 0.92, p = .006) and depression (aOR = 0.93, p = .003) symptoms. Family function significantly moderated the relationship between sleep health and scores of anxiety (β = 0.01, p = .013) and depression (β = 0.01, p < .001) symptoms.

Conclusion: Good sleep health in late pregnancy is associated with reduced anxiety and depression symptoms, with a stronger association found in pregnant women with weaker family function.

Objectives: This study aims to evaluate the association between ecological assessment experience of loneliness and nocturnal sleep in a sample of healthy adolescents and to investigate the potential mediating role of pre-sleep worry in this relationship.

Methods: Each evening, participants completed an electronic diary including items assessing loneliness and worry. The time of diary administration was set on an individual basis to capture the actual pre-bed experience. Sleep parameters were assessed using actigraphy.

Results: Analyses were conducted on 72 participants (53.9% boys; M_age = 15.65; SD = 1.32) and 535 nights. Multilevel structural equation modeling indicated that within person loneliness fluctuations over the assessment period predicted shorter sleep duration through the mediation of high pre-sleep worry (B = -1.634, p = .027); More specifically, at the within level, loneliness was significantly and positively related to worry (B = .131, p = .001), which in turn was negatively related to sleep duration (B = -12.502, p = .028).One step increase in loneliness-associated pre-sleep worry predicted a decrease of 12 minutes in sleep duration. The mediation path was not influenced by anxiety and gender differences in the adjusted analysis. Results on other sleep parameters were not significant.

Conclusions: Findings suggest that adolescents' loneliness experienced at bedtime may influence sleep duration through worry. Sleep-promoting interventions in adolescents may benefit from targeting loneliness and pre-sleep cognitions.

Objectives: Individuals who are at higher risk for suicide commonly report sleep disorder symptoms. There is a need for increased precision in understanding which sleep disorder symptoms are most reported in at-risk populations, as well as variability in sleep disorder symptoms. The current study comprehensively evaluates sleep problems in US Active-Duty Military Personnel with acute suicide risk.

Methods: Active-duty treatment-seeking US Marines (N = 40) were recruited based on suicide ideation with intent/plan/suicide attempt in the past month. Marines completed a structured clinical interview for sleep disorders and self-report questionnaires.

Results: Almost all (97.5%) of the participants met criteria for at least one sleep disorder, including insomnia (75.0%), nightmare disorder (50.0%), circadian rhythm sleep-wake disorders (27.5%), and possible obstructive sleep apnea-hypopnea syndrome (25.0%). There was not able variability in total sleep duration (5.45-7.01 hr per night) and bedtimes (19:30-1:00 workdays; 19:30-5:30 weekends), and poor average sleep efficiency (63.28% on weekdays and 69.43% on weekends).

Conclusions: These results underscore our hypothesis that sleep problems are prevalent among military personnel at high risk for suicide. There is a need for a more precise assessment of sleep disorder symptoms among service members who are at high risk for suicide, as well as expanded intervention opportunities in this group.

Objectives: Individual sleep characteristics have been shown to independently influence physical and mental health in older adults, but these characteristics are often interdependent. However, few studies have explored multidimensional sleep health in relation to self-rated health outcomes among retired older adults, particularly with regard to sex differences. This study examined the associations between multidimensional sleep health, and self-rated physical and mental (i.e. depressive symptoms) health in retired older adults (M years of retirement = 6.59), stratified by sex.

Methods: Participants (n = 154; Mage = 68.4, 55.2% female) reported physical health (RAND-12) and depressive symptoms (CES-D). Multidimensional sleep health was measured using wrist actigraphy to assess sleep efficiency, timing, duration, and regularity, and sleep diaries to evaluate daytime alertness and sleep satisfaction. Each component was dichotomized and summed for a composite score (0-6). Hierarchical linear regressions examined the relationships between multidimensional sleep health and health outcomes.

Results: Women had poorer multidimensional sleep health compared to men. In the full sample, poorer multidimensional sleep health was associated with worse self-rated physical health and depressive symptoms. Sex-stratified analyses revealed significant associations only in women.

Conclusion: Multidimensional sleep health is associated with self-rated physical health and depressive symptoms in older retired women. Future research should explore why sleep health may be more salient for self-rated physical health and depressive symptoms in women vs. men and their links to health outcomes, providing insights for tailored interventions.

Objectives: Although there are increasing reports suggesting that sexual minorities sleep badly, very few empirical studies have used standard sleep measures. Moreover previous studies have not considered the ways in which different identities and identity processes may interact with sleep.

Methods: We addressed this in an on-line sample of almost 300 self-identified lesbian women (N = 40), gay men (N = 55) and bisexual men (N = 87)and bisexual women (N = 118). We assessed sleep using the Pittsburgh Sleep Quality Index, Insomnia Severity Index and Epworth Sleepiness Scale, among others; wellbeing using measures of life satisfaction, anxiety and depression, and lesbian, gay and bisexual (LGB) identification, social support, discrimination, identity resilience and minority stressors.

Results: All sleep measures suggested that sexual minorities sleep poorly, and experience identity challenges, minority stressors, high levels of anxiety and depression and reduced life satisfaction. The latter wellbeing variables and BMI account for substantial amounts of variance in scores on standard sleep measures, as do identity and minority stressors. These variables mediate each other such that a confident sexual identity is associated with reduced effects of minority stressors on sleep, and enhanced wellbeing and sleep. There were no differences between LGB subgroups in these effects, except for insomnia, which was worse in bisexuals than in lesbian and gay individuals.

Conclusions: Standard self-report measures of sleep confirm that sexual minorities sleep poorly, and identification with or stresses due to minority status exascerbates this.

Objective: People living with HIV (PLWH) commonly face a range of health issues, among which sleep disturbances are common and are related to adverse health outcomes. This review aims to assess the pooled prevalence of sleep disturbances among PLWH in China through a comprehensive and quantitative meta-analysis.

Methods: We conducted comprehensive searches of Chinese databases and international databases from their inception to December 23, 2023. The random effects model was used to calculate the pooled prevalence estimates with a 95% confidence interval.

Results: This meta-analysis included 20 studies involving 12,256 Chinese PLWH, 5,542 PLWH of whom experienced sleep disturbances. The pooled prevalence was 46% (95% CI: 42-51%). Subgroup analysis revealed that the prevalence of sleep disturbances was influenced by the mental status of depression (Q = 4.21, p < .001) and anxiety (Q = 4.76, p < .001), receiving support from family and friends (Q = 6.63, p < .001), treatment with Efavirenz (Q = 37.53, p = .007), studies using different instruments (Q = 42.69, p < .001) and those using different cutoff values of PSQI (Q = 48.29, p < .001). Meta-regression analysis revealed that the covariates, including mean age, female proportion, publication year, and quality score, were not significant moderators of heterogeneity (p > .05).

Conclusions: Chinese PLWH experience a significant burden of sleep disturbances. Early screening and comprehensive interventions targeting sleep disturbances in this population should be prioritized to improve their overall well-being and quality of life.

Objective: This study investigates the moderating effects of maternal self-efficacy on the association between infant sleep quality and various aspects of maternal mental and emotional health.

Method: Five hundred forty-four mothers (M age = 32.27, SD = 4.29) of infants and toddlers aged 0 to 36 months completed a combination of self-report and parent-report measures: the Brief Infant Sleep Questionnaire-Revised (BISQ-R) for infant sleep quality, the Maternal Self-Efficacy Scale (MSES), the Depression Anxiety Stress Scale-21 (DASS-21), the Pittsburgh Sleep Quality Index (PSQI), the Satisfaction with Life Scale (SWLS), and the Subjective Happiness Scale (SHS).

Results: Mothers with higher self-efficacy reported better well-being across all domains compared to those with lower self-efficacy. Furthermore, maternal self-efficacy scores were found to moderate the relationship between infant sleep and maternal well-being. While poor infant sleep quality was associated with lower well-being scores across all mothers, the positive association between good infant sleep quality and well-being was more pronounced among mothers with higher self-efficacy scores.

Conclusions: Our findings highlight the moderating role of maternal self-efficacy in the relationship between maternal well-being and infant/toddler sleep. These results suggest that interventions for enhancing maternal self-efficacy may offer a promising avenue for improving maternal well-being, potentially in conjunction with behavioral interventions targeting child sleep problems.