Behavioral Sleep Medicine最新文献

Background: Compared to the general population, military personnel are at increased risk for insomnia and poor psychological well-being. The present study: (1) compared categories of insomnia severity between cadets of the Swiss Armed Forces (SAF) and previously published norms and (2) investigated the associations between insomnia and psychological well-being related to perceived stress, mental toughness, dark triad traits, and organizational citizenship behavior (OCB).

Methods: A total of 216 cadets of the SAF (mean age: 20.80 years) completed self-rating questionnaires covering sociodemographic information, insomnia, perceived stress, mental toughness, dark triad, and organizational citizenship behavior. Data on insomnia sum scores and categories of historical samples (862 young adults and 533 police and emergency response service officers) were used for comparison.

Results: Cadets of the SAF reported higher insomnia sum scores and insomnia severity categories, compared to young adults and police officers. Higher scores for insomnia were associated with higher scores for stress, dark triad traits, and with lower scores for mental toughness and OCB. Categories of low, medium, and high stress moderated the association between insomnia and dark triad traits.

Conclusions: Compared to norms of the general population, cadets of the SAF reported a higher insomnia severity. Given that standardized treatment programs for insomnia, mental toughness, and above all for coping with stress are available, such interventions might be promising avenues to improve a cadet's overall sleep, psychological well-being, and behavior.

Objectives: Sleep and internalizing problems escalate during adolescence and can negatively impact long-term health. However, the directionality of this risk-relationship remains poorly understood within a developmental context. The current study aimed to determine the directionality of this relationship in adolescents with no history of psychiatric disorder and whether sex at birth played a role in this relationship.

Methods: We used data from the Adolescent Brain Cognitive Development, an ongoing multisite longitudinal US study, that covered four waves (W1:9-11 years; W2:10-12 years; W3:11-13 years; W4:12-14 years). Analyses included 3,128 youth (50.99%girls) with no past or current psychiatric disorders at W1. The Sleep Disturbance Scale for Children and the Child Behavior Checklist were used to measure sleep and internalizing problems. Cross-lagged panel models were used to evaluate the cross-lagged relationships across waves.

Results: The sleep-internalizing cross-lagged relationship was unidirectional, with medium-large effect sizes: greater total sleep problems were associated with more severe internalizing problems at later waves (W2➔W3, coefficient = 0.052, p = .021; W3➔W4, coefficient = 0.091, p < .001), with problems in initiating and maintaining sleep predicting internalizing problems early on. Girls showed greater sleep-internalizing risk than boys.

Conclusions: Sleep-internalizing relationships change across adolescence, becoming significant and more specific from early to mid-adolescence. Sleep interventions delivered in early adolescence, to girls in particular, may have a positive short and long-term impact on internalizing outcomes.

Objective: Discrimination disrupts sleep and contributes to race-based health inequities for Black Americans, but less is known about the psychological mechanisms underlying this relation. The current work tests whether emotion invalidation, termed Social Pain Minimization (SPM), mediates discrimination's negative effects on sleep quality. We focus on the experiences of Black Americans because of racism's disproportionate effect on the health outcomes of Black individuals in the U.S.

Methods: Four studies with cross-sectional (Studies 1a-1b) and cross-lagged panel designs (Studies 2-3; N_total = 1,176) were used. Discrimination and SPM were assessed with established measures and self-reported sleep quality was assessed with three different operationalizations including the short form Patient-Reported Outcomes Measurement Information System (PROMIS) Sleep-Related Impairment (SRI) subscale and composites of the Insomnia Severity Index (ISI).

Results: Cross-sectional (Studies 1a-1b) and longitudinal mediation analyses (Studies 2-3) indicated discrimination's negative effect on sleep quality partially operated through SPM (Study 1a, 95% CI = [-.24, -.016]); Study 1b, 95% CI = [-.22, -.03]; Study 2, 95% CI = [-.268, -.007]]; Study 3, 95% CI = [-0.043, -.002]).

Conclusion: Beyond its direct negative effect on sleep, discrimination also operates through SPM to reduce sleep quality. Emotion invalidation stemming from discrimination damages sleep.

Objective: We investigated the relationship between irregular sleep-wake patterns and other aspects of sleep and mental health among adolescents.

Methods: Community-based sample of adolescents (n = 200, mean age 16.8; 61.7% female) completed baseline assessment (i.e. sleep quality, daytime sleepiness, depressive symptoms, social anhedonia, problematic alcohol use), and 7-8 consecutive days of wearing wrist actigraphy. Irregular sleep-wake patterns were assessed via two methods, both based on actigraphy, to capture day-to-day irregularity (intraindividual variability, IIV) and weekly irregularity (social jet lag, SJL). The Bayesian variability method was performed to calculate IIV in total sleep time (TST), sleep onset, and offset time. SJL was quantified as the actual difference in the sleep midpoint on school days versus non-school days.

Results: Greater IIV in TST was associated with poorer sleep quality (B = 1.66, 95% CI, 0.14, 3.31, p < .05), and greater depressive symptoms (B = 0.72, 95% CI, 0.17, 1.35, p < .05), while greater IIV in sleep offset time was associated greater depressive symptoms (B = 0.63, 95% CI, 0.03, 1.28, p < .05), and greater problematic alcohol use (B = 0.70, 95% CI, 0.12, 1.35, p < .05), all after adjusting for age, sex, family SES, alcohol drinks, and SJL. No significant association was found with sleep onset time. Greater SJL was associated with poorer sleep quality (B = 0.40, 95% CI, 0.27, 0.54, p < .001) and fewer problematic alcohol uses (B = -0.05, 95% CI, -0.09, -0.00, p < .05), when adjusting for age, sex, family SES, and alcohol drinks.

Conclusion: Our findings add to a growing body of research on irregularity in sleep-wake patterns and clinical implications.

Objectives: Sleep disorder is a growing public health concern that requires attentive assessment and treatment. However, the length of assessment tools for sleep disorders, including insomnia, hinders their use in both research and clinical settings. Brief assessment measures expedite assessment time, reducing respondent burden, and save resources, especially in resource-limited settings.

Methods: This study investigated the validity and reliability of a short three-item insomnia scale, the Insomnia Severity Index-3 (ISI-3) and established two cutoff scores in a sample of 238 healthcare providers in Oman (45.8% physicians and 54.2% nurses).

Results: The ISI-3 demonstrated good convergent and divergent validity. The receiver operator characteristic recommended two cutoff scores of > 4 (a sensitivity of 0.87.3 and a specificity of 0.96.4) and > 6 (a sensitivity of 0.96.9 and a specificity of 0.97.1).

Conclusions: The ISI-3 is a good assessment index of insomnia, especially when the utilization of the full insomnia index is unfeasible.

Objectives: In this meta-regression, we aimed to explore associations between changes in psychosocial factors and changes in sleep disturbance during mindfulness-based interventions (MBIs). We also investigated participant-specific and methodological factors associated with sleep disturbance during MBIs.

Method: We utilized data from a published meta-analysis of 40 randomized controlled trials of MBIs (published from inception to 2020) with a sleep disturbance outcome measure in healthy and clinical adult populations. We conducted meta-regressions to test associations between sleep improvements following MBIs and psychosocial factors, as well as demographic and methodological factors.

Results: MBIs were associated with significant reductions in sleep disturbance (SMD = -0.523; 95% CI = -0.678 to -0.368) and psychosocial factors (SMD = -0.213 - -0.894). Reductions in sleep disturbance were associated with reductions in stress (r = 0.74, p = .02) and depression (r = 0.90, p < .001).

Conclusions: MBIs improve sleep disturbance across a wide range of healthy and clinical populations. Stress and depression may be important psychosocial factors associated with sleep disturbance. Future RCTs should include measures of additional factors and should investigate longitudinal associations between psychosocial, demographic, and methodological factors with changes in sleep disturbance to test mechanisms and to identify "active ingredients" of MBIs.

Objectives: Bedtime procrastination has been identified as an important factor associated with insufficient sleep and health and well-being problems. This study aims to investigate factor structure and psychometric properties of Bedtime procrastination Scale (BPS) in the Persian-speaking community. Additionally, this research aims to examine the role of bedtime procrastination in predicting sleep-related problems.

Method: Four hundred and thirty-three participants (average age 23 years, 55.7% female) took part in this study. All participants completed the BPS, the Insomnia Severity Index (ISI), and the Tuckman Procrastination Scale (TPS). Confirmatory factor analysis and hierarchical regression analysis were used to examine the factor structure and predict sleep-related problems.

Results: Confirmatory factor analysis showed that, unlike other language versions, the two-factor model without item 3 was the most suitable structure. This scale demonstrated acceptable reliability and validity. Additionally, the results of hierarchical regression analysis indicated that the procrastination factor, especially bedtime procrastination, was the best predictor of insomnia severity.

Conclusion: In this study, the Persian version of BPS showed strong validity and reliability. These findings suggest that the Persian BPS can serve as a valuable and comprehensive research tool for assessing bedtime procrastination.

Objectives: A preference for eveningness - one's perception of being most alert later in the day - is associated with negative developmental outcomes in adolescence. Sleep onset consistency is protective against such outcomes. Toward a more nuanced understanding of relations between sleep-wake processes and adolescent development, we examined weeknight sleep onset consistency as a moderator of relations between eveningness and multiple indicators of development.

Method: A sample of 272 high-school students (M_age = 17 years, SD = 9.12 months; n = 133 identified as female; 41% non-Hispanic Black/African-American, 59% non-Hispanic White/European-American) participated in a week of at-home sleep actigraphy assessment in 2017-2018. Adolescents reported their morningness - eveningness, internalizing symptoms (depression, anxiety), positive affect (optimism and subjective happiness), and physical health, and mothers reported on youths' behavior problems. Relations were examined between morningness - eveningness and each indicator of development; sleep onset consistency was examined as a moderator of these associations.

Results: On average, adolescents with a preference for eveningness had higher levels of externalizing behaviors and internalizing symptoms and lower levels of positive affect and physical health compared to peers with a preference for morningness (Bs = -0.27*-0.12***). Each association was moderated by weeknight sleep onset consistency. Across all indicators of development, evening-preferring youth with more consistent weeknight sleep onset had 0.49-0.72 SD better outcomes on average than evening-preferring youth with less consistent weeknight sleep onset.

Conclusions: Falling asleep at roughly the same time each night can protect adolescent night owls from behavior problems and internalizing symptoms and can promote their positive affect and physical health.

Objectives: This study aimed to investigate the factors affecting patient perceptions of sleep concerns and the need for treatment to understand and enable effective management.

Methods: This cross-sectional study analyzed data collected between November 2018 and October 2022 at the sleep clinic of a tertiary hospital. Adults aged > 19 years who completed sleep questionnaires and polysomnography (PSG) were included. Logistic regression models were used to assess the associations between demographic, clinical, and social factors, sleep questionnaire responses, and PSG data with self-reported sleep concerns (n = 3,457) and perceived need for treatment(n = 3,135).

Results: Insomnia-related symptoms affect both sleep concerns and need for treatment, and sleep maintenance is the most influential factor in both sleep concerns (odds ratio[OR] = 19.74, 95% confidence interval[CI] 6.17-63.20) and need for treatment (OR = 3.84, 95% CI 2.19-6.73). Young age (OR = 2.66, 95% CI 1.38-5.12), employment status, and daily life dysfunction were determinants of treatment readiness. None of the PSG parameters showed an independent association with sleep concerns or need for treatment.

Conclusions: Sleep maintenance problems had the most profound effect on sleep concerns and the need for treatment. Social needs are key factors in seeking treatment. A discrepancy has been noted between the effects of subjective and objective factors on sleep concerns and the need for treatment; therefore, patient management should pay attention to subjective sleep complaints.