Pub Date : 2024-04-08DOI: 10.3389/frsle.2024.1351691
Talia Barrow, Bryan Yu, Carly Cooper, Elaina Dalomba, Brian Gregg, Maria Barefield, Jon Umlauf
Most U.S. Servicemembers (SMs) get less than the recommended amount of sleep per night, which has been shown to be directly influenced by local leadership. Previous research demonstrated that a brief sleep leadership training (SLT) protocol resulted in improved knowledge and attitudes regarding sleep among U.S. Army leaders, and improvements in the sleep health of their SMs. Human Performance Teams (HPT) offer one solution to propel the cultural change related to sleep, however, little is known about HPT members' own sleep related knowledge, practices, attitudes, and beliefs. This mixed-methods study determined the effect of (SLT) on the sleep-related knowledge, practices, attitudes, beliefs, and perceived competency of HPT members, explored their experiences addressing SM sleep, and gauged their perceived value in receiving the training. Thirty-one individuals received 2 days of SLT. Baseline and 6-week post training follow-up measures were collected, and participants were invited to participate in semi-structured interviews to explore their unique experiences addressing sleep, as well as their perceived value in receiving SLT. Training had no significant effects on HPT members' sleep practices or sleep beliefs, some significant effects on their attitudes and knowledge about sleep, and significant effects on their perceived competence to address sleep in their units. Results suggest that HPT members benefited from the training through enhancement of their competence to address sleep with leadership. However, they struggle to obtain sufficient sleep themselves. More research is needed to identify methods of overcoming specific barriers to sleep imposed on SMs.
{"title":"The effect of Sleep Leadership Training on U.S. Army human performance team members","authors":"Talia Barrow, Bryan Yu, Carly Cooper, Elaina Dalomba, Brian Gregg, Maria Barefield, Jon Umlauf","doi":"10.3389/frsle.2024.1351691","DOIUrl":"https://doi.org/10.3389/frsle.2024.1351691","url":null,"abstract":"Most U.S. Servicemembers (SMs) get less than the recommended amount of sleep per night, which has been shown to be directly influenced by local leadership. Previous research demonstrated that a brief sleep leadership training (SLT) protocol resulted in improved knowledge and attitudes regarding sleep among U.S. Army leaders, and improvements in the sleep health of their SMs. Human Performance Teams (HPT) offer one solution to propel the cultural change related to sleep, however, little is known about HPT members' own sleep related knowledge, practices, attitudes, and beliefs. This mixed-methods study determined the effect of (SLT) on the sleep-related knowledge, practices, attitudes, beliefs, and perceived competency of HPT members, explored their experiences addressing SM sleep, and gauged their perceived value in receiving the training. Thirty-one individuals received 2 days of SLT. Baseline and 6-week post training follow-up measures were collected, and participants were invited to participate in semi-structured interviews to explore their unique experiences addressing sleep, as well as their perceived value in receiving SLT. Training had no significant effects on HPT members' sleep practices or sleep beliefs, some significant effects on their attitudes and knowledge about sleep, and significant effects on their perceived competence to address sleep in their units. Results suggest that HPT members benefited from the training through enhancement of their competence to address sleep with leadership. However, they struggle to obtain sufficient sleep themselves. More research is needed to identify methods of overcoming specific barriers to sleep imposed on SMs.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140731349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-05DOI: 10.3389/frsle.2024.1346642
T. Blackwell, Sarah C. Robinson, Nicholas Thompson, L. Dean-Gilley, Phillip Yu, Alice Pressman, Katie L. Stone
Sleep in the hospital setting is understudied, with limited literature describing measurement of sleep quality. This study among older inpatients in an acute-care hospital describes sleep characteristics both objectively and subjectively, and explores the associations of sleep with hospital outcomes.Older patients (n = 112) at Sutter Tracy Community Hospital were enrolled from January 2016 to November 2017. Sleep prior to admission was measured subjectively [Pittsburgh Sleep Quality Index (PSQI)], while sleep during hospitalization was measured subjectively (sleep diaries) and objectively (actigraphy, averaged over all nights). Outcomes measured included change in cognition during the hospital stay (i.e., Montreal Cognitive Assessment), length of stay (LOS), discharge to a skilled nursing facility (SNF), and re-admittance to a hospital within 30 days of discharge.The participants were on average 68.7 ± 6.5 years old, predominately white (77%) and 55% women. Average PSQI was high (9.1 ± 4.2) indicating poor sleep quality prior to admission. Actigraphy was well-tolerated, with most (89%) having complete data. Sleep during the hospital stay was disturbed, with low levels of total sleep time (5.6 ± 2.0 h) and high levels of fragmentation (sleep efficiency 68.4 ± 15.0%). Sleep interruption was reported on 71% of sleep diaries, with the most common reasons being due to medical care [measurement of vitals (23%), staff interruptions (22%), blood draws (21%)]. Those with lower sleep efficiency had more cognitive decline upon discharge. Although underpowered, there was a suggestion of an association with poor sleep and the likelihood of being discharged to a SNF. Those with worse self-reported sleep quality (PSQI) prior to admission had a slightly longer LOS. No associations were seen with sleep quality and likelihood of readmission.Collection of objective and subjective sleep measures was feasible among hospitalized older adults. Disrupted sleep was common, and was potentially related to poor hospital outcomes. Our next steps will be to leverage these results to design and implement an intervention to improve sleep in hospitalized adults.
{"title":"Objective and subjective sleep characteristics in hospitalized older adults and their associations to hospital outcomes","authors":"T. Blackwell, Sarah C. Robinson, Nicholas Thompson, L. Dean-Gilley, Phillip Yu, Alice Pressman, Katie L. Stone","doi":"10.3389/frsle.2024.1346642","DOIUrl":"https://doi.org/10.3389/frsle.2024.1346642","url":null,"abstract":"Sleep in the hospital setting is understudied, with limited literature describing measurement of sleep quality. This study among older inpatients in an acute-care hospital describes sleep characteristics both objectively and subjectively, and explores the associations of sleep with hospital outcomes.Older patients (n = 112) at Sutter Tracy Community Hospital were enrolled from January 2016 to November 2017. Sleep prior to admission was measured subjectively [Pittsburgh Sleep Quality Index (PSQI)], while sleep during hospitalization was measured subjectively (sleep diaries) and objectively (actigraphy, averaged over all nights). Outcomes measured included change in cognition during the hospital stay (i.e., Montreal Cognitive Assessment), length of stay (LOS), discharge to a skilled nursing facility (SNF), and re-admittance to a hospital within 30 days of discharge.The participants were on average 68.7 ± 6.5 years old, predominately white (77%) and 55% women. Average PSQI was high (9.1 ± 4.2) indicating poor sleep quality prior to admission. Actigraphy was well-tolerated, with most (89%) having complete data. Sleep during the hospital stay was disturbed, with low levels of total sleep time (5.6 ± 2.0 h) and high levels of fragmentation (sleep efficiency 68.4 ± 15.0%). Sleep interruption was reported on 71% of sleep diaries, with the most common reasons being due to medical care [measurement of vitals (23%), staff interruptions (22%), blood draws (21%)]. Those with lower sleep efficiency had more cognitive decline upon discharge. Although underpowered, there was a suggestion of an association with poor sleep and the likelihood of being discharged to a SNF. Those with worse self-reported sleep quality (PSQI) prior to admission had a slightly longer LOS. No associations were seen with sleep quality and likelihood of readmission.Collection of objective and subjective sleep measures was feasible among hospitalized older adults. Disrupted sleep was common, and was potentially related to poor hospital outcomes. Our next steps will be to leverage these results to design and implement an intervention to improve sleep in hospitalized adults.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140735695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-03DOI: 10.3389/frsle.2024.1359723
Gabriel R. Gilmore, Anna L. Smith, Fallon B. Dickinson, A. Crosswell, Wendy Berry Mendes, Lauren N. Whitehurst
Sleep and stress processes shape executive function. Evidence suggests that poor sleep regulation can lead to significant impairments in executive functions. Psychological stress can also directly impact a variety of executive functions, often leading to declines, but may additionally reduce executive function via its negative impact on sleep. Rates of perceived stress and poor sleep have skyrocketed in recent years. As such, it has become increasingly important to understand how daily stress exposures and sleep processes modulate executive functions.In a remote 21-day app-based study, 227 participants completed sleep and stress assessments three times a day. They also completed three executive functioning tasks at various timepoints across the 21-day study interval that assessed cognitive inhibition (Emotional Stroop task), cognitive flexibility (Trail Making Test A and B), and working memory (Backwards Digit Span).Participants with consistent sleep/wake schedules reported fewer acute stress events when compared to those with inconsistent sleep schedules. Those with greater sleep/wake regularity also had faster responses to self-relevant negative probes (vs. general negative and neutral) in the Stroop task. Further, variability in sleep/wake timing and reported acute stress exposures across the 21-day study interval interacted to predict performance on the Emotional Stroop task. Specifically, as the number of acute stress events experienced across the 21-day interval increased, participants with more regular sleep schedules had slower overall response times on the Stroop. Higher acute stress exposures led to specific response time delays to neutral and self-relevant negative probes for those with high sleep/wake regularity. We found no impact of the number of acute stress events or stress intensities on working memory span, Stroop accuracy, or Trails response time.These data may indicate that sleep/wake regularity preserves adaptive inhibitory control responses to cumulative acute stress.
{"title":"Sleep/wake regularity influences how stress shapes executive function","authors":"Gabriel R. Gilmore, Anna L. Smith, Fallon B. Dickinson, A. Crosswell, Wendy Berry Mendes, Lauren N. Whitehurst","doi":"10.3389/frsle.2024.1359723","DOIUrl":"https://doi.org/10.3389/frsle.2024.1359723","url":null,"abstract":"Sleep and stress processes shape executive function. Evidence suggests that poor sleep regulation can lead to significant impairments in executive functions. Psychological stress can also directly impact a variety of executive functions, often leading to declines, but may additionally reduce executive function via its negative impact on sleep. Rates of perceived stress and poor sleep have skyrocketed in recent years. As such, it has become increasingly important to understand how daily stress exposures and sleep processes modulate executive functions.In a remote 21-day app-based study, 227 participants completed sleep and stress assessments three times a day. They also completed three executive functioning tasks at various timepoints across the 21-day study interval that assessed cognitive inhibition (Emotional Stroop task), cognitive flexibility (Trail Making Test A and B), and working memory (Backwards Digit Span).Participants with consistent sleep/wake schedules reported fewer acute stress events when compared to those with inconsistent sleep schedules. Those with greater sleep/wake regularity also had faster responses to self-relevant negative probes (vs. general negative and neutral) in the Stroop task. Further, variability in sleep/wake timing and reported acute stress exposures across the 21-day study interval interacted to predict performance on the Emotional Stroop task. Specifically, as the number of acute stress events experienced across the 21-day interval increased, participants with more regular sleep schedules had slower overall response times on the Stroop. Higher acute stress exposures led to specific response time delays to neutral and self-relevant negative probes for those with high sleep/wake regularity. We found no impact of the number of acute stress events or stress intensities on working memory span, Stroop accuracy, or Trails response time.These data may indicate that sleep/wake regularity preserves adaptive inhibitory control responses to cumulative acute stress.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140746653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-28DOI: 10.3389/frsle.2024.1340729
S. Karsan, Tara Kuhn, Michelle Ogrodnik, Laura E. Middleton, J. Heisz
Poor mental health is a known risk factor for poor sleep among university students; however, less is known about the role of dysfunctional sleep beliefs and its relation to mental health and sleep. Additionally, students who identify as people of color (POC) may experience unique stressors related to discrimination and inequalities which can contribute to mental health issues and in turn, influence their sleep. The present study evaluated the impact of dysfunctional sleep beliefs and poor mental health on a student's susceptibility to worse sleep and examined differences among POC.Post-secondary students completed a survey including the Insomnia Severity Index and the Dysfunctional Beliefs and Attitudes about Sleep Scale. Participants also completed questionnaires measuring symptoms of depression, anxiety, and perceived stress.One thousand five hundred and sixty-two students were included in the analyses, 58% of which were POC. POC students had more dysfunctional sleep beliefs (p < 0.01) and worse insomnia severity (p < 0.01) compared to white students. Overall, greater dysfunctional sleep beliefs were significantly associated with worse symptoms of depression (b = 1.521), anxiety (b = 1.170), stress (b = 1.370), and poor sleep (b =1.963; ps < 0.001). Dysfunctional sleep beliefs also moderated the relation between poor mental health and sleep, specifically depression (p = 0.035) and anxiety (p = 0.007), by exacerbating sleep outcomes.The results suggest that dysfunctional sleep beliefs may play a role in perpetuating poor mental health and sleep. Interventions to improve students' sleep and wellbeing focused on reframing dysfunctional sleep beliefs should be examined.
{"title":"Exploring the interactive effect of dysfunctional sleep beliefs and mental health on sleep in university students","authors":"S. Karsan, Tara Kuhn, Michelle Ogrodnik, Laura E. Middleton, J. Heisz","doi":"10.3389/frsle.2024.1340729","DOIUrl":"https://doi.org/10.3389/frsle.2024.1340729","url":null,"abstract":"Poor mental health is a known risk factor for poor sleep among university students; however, less is known about the role of dysfunctional sleep beliefs and its relation to mental health and sleep. Additionally, students who identify as people of color (POC) may experience unique stressors related to discrimination and inequalities which can contribute to mental health issues and in turn, influence their sleep. The present study evaluated the impact of dysfunctional sleep beliefs and poor mental health on a student's susceptibility to worse sleep and examined differences among POC.Post-secondary students completed a survey including the Insomnia Severity Index and the Dysfunctional Beliefs and Attitudes about Sleep Scale. Participants also completed questionnaires measuring symptoms of depression, anxiety, and perceived stress.One thousand five hundred and sixty-two students were included in the analyses, 58% of which were POC. POC students had more dysfunctional sleep beliefs (p < 0.01) and worse insomnia severity (p < 0.01) compared to white students. Overall, greater dysfunctional sleep beliefs were significantly associated with worse symptoms of depression (b = 1.521), anxiety (b = 1.170), stress (b = 1.370), and poor sleep (b =1.963; ps < 0.001). Dysfunctional sleep beliefs also moderated the relation between poor mental health and sleep, specifically depression (p = 0.035) and anxiety (p = 0.007), by exacerbating sleep outcomes.The results suggest that dysfunctional sleep beliefs may play a role in perpetuating poor mental health and sleep. Interventions to improve students' sleep and wellbeing focused on reframing dysfunctional sleep beliefs should be examined.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140369886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-19DOI: 10.3389/frsle.2024.1351660
A. Newton, Graham J. Reid
Most children cease napping between 2 and 5 years old. Little is known about the predictors of this cessation. Parents' sleep-related beliefs aid in understanding children's nighttime sleep behaviors, but few index daytime sleep beliefs.Two measures of parents' napping beliefs were developed and evaluated-the Parents' Nap Beliefs Scale (14 items) and the Reasons Children Nap Scale (19 items). Canadian parents of 1–5-year-old children completed these questionnaires and other sleep-related measures in independent pilot (n = 201) and replication (n = 702) samples. In the replication sample, a subsample of parents also completed 1–3 weeks of daily sleep diaries. The samples were representative of the Canadian population by ethnicity and region.In both samples, both measures demonstrated strong construct validity, convergent and divergent validity, and internal consistency. The Parents' Nap Beliefs Scale was composed of two factors: (a) Positive Beliefs and (b) Negative Beliefs about napping. The Reasons Children Nap Scale was composed of two higher order factors and five lower order factors: (a) Encouragement Reasons (Child related; Parent related) and (b) Discouragement Reasons (Child prefers not to nap; Child functions well without a nap; Scheduling).Future research should (a) test these scales as longitudinal determinants of children's nap behavior and cessation, (b) evaluate parental Nap Beliefs in non-Western cultures, and (c) adapt these scales for use with childcare providers.
{"title":"Parents, preschoolers, and napping: the development and psychometric properties of two Nap Belief Scales in two independent samples","authors":"A. Newton, Graham J. Reid","doi":"10.3389/frsle.2024.1351660","DOIUrl":"https://doi.org/10.3389/frsle.2024.1351660","url":null,"abstract":"Most children cease napping between 2 and 5 years old. Little is known about the predictors of this cessation. Parents' sleep-related beliefs aid in understanding children's nighttime sleep behaviors, but few index daytime sleep beliefs.Two measures of parents' napping beliefs were developed and evaluated-the Parents' Nap Beliefs Scale (14 items) and the Reasons Children Nap Scale (19 items). Canadian parents of 1–5-year-old children completed these questionnaires and other sleep-related measures in independent pilot (n = 201) and replication (n = 702) samples. In the replication sample, a subsample of parents also completed 1–3 weeks of daily sleep diaries. The samples were representative of the Canadian population by ethnicity and region.In both samples, both measures demonstrated strong construct validity, convergent and divergent validity, and internal consistency. The Parents' Nap Beliefs Scale was composed of two factors: (a) Positive Beliefs and (b) Negative Beliefs about napping. The Reasons Children Nap Scale was composed of two higher order factors and five lower order factors: (a) Encouragement Reasons (Child related; Parent related) and (b) Discouragement Reasons (Child prefers not to nap; Child functions well without a nap; Scheduling).Future research should (a) test these scales as longitudinal determinants of children's nap behavior and cessation, (b) evaluate parental Nap Beliefs in non-Western cultures, and (c) adapt these scales for use with childcare providers.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140229133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-14DOI: 10.3389/frsle.2024.1365784
Yusuke Arai, D. Sasayama, Kazuhiro Suzuki, Jun Watanabe, Yuta Kuraishi, Mika Koido, S. Washizuka
This report describes the case of a 13-year-old boy with chronic insomnia and increased daytime sleepiness linked to excessive nocturnal media use. Implementing a restriction on digital device usage after 9 pm led to a significant improvement in the sleep duration with no adverse event. Throughout the 16-week treatment period, the total sleep time of the patient normalized, and the daytime sleepiness problem was resolved. This is an indication that the treatment was effective. This case emphasizes the potential of nighttime screentime restriction in treating pediatric chronic insomnia and highlights the importance of addressing screen time in sleep disorder management.
{"title":"Case report: Nighttime media restriction for pediatric insomnia","authors":"Yusuke Arai, D. Sasayama, Kazuhiro Suzuki, Jun Watanabe, Yuta Kuraishi, Mika Koido, S. Washizuka","doi":"10.3389/frsle.2024.1365784","DOIUrl":"https://doi.org/10.3389/frsle.2024.1365784","url":null,"abstract":"This report describes the case of a 13-year-old boy with chronic insomnia and increased daytime sleepiness linked to excessive nocturnal media use. Implementing a restriction on digital device usage after 9 pm led to a significant improvement in the sleep duration with no adverse event. Throughout the 16-week treatment period, the total sleep time of the patient normalized, and the daytime sleepiness problem was resolved. This is an indication that the treatment was effective. This case emphasizes the potential of nighttime screentime restriction in treating pediatric chronic insomnia and highlights the importance of addressing screen time in sleep disorder management.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140241725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-13DOI: 10.3389/frsle.2024.1355468
A. Sweetman, C. Reynolds, L. Lack, Andrew Vakulin, C. Chai-Coetzer, Douglas M. Wallace, Megan Crawford, C. Richardson
Therapist-delivered Cognitive Behavioral Therapy for Insomnia (CBTi) is an effective but largely inaccessible treatment for people with Co-Morbid Insomnia and Sleep Apnea (COMISA). To increase CBTi access for COMISA, we aimed to develop a self-guided interactive 5-session digital CBTi program that is appropriate for people with insomnia-alone and COMISA, and compare its effectiveness between people with insomnia-alone, vs. comorbid insomnia and high-risk sleep apnea.Data from 62 adults with insomnia symptoms were used. High-risk sleep apnea was defined as a score of ≥5 on the OSA50. Participants self-reported symptoms of insomnia (ISI), depression, anxiety, sleepiness (ESS), fatigue, and maladaptive sleep-related beliefs (DBAS-16) at baseline, 8-week, and 16-week follow-up. ESS scores were additionally assessed during each CBTi session. Intent-to-treat mixed models and complete-case chi2 analyses were used.There were more participants with insomnia-alone [n = 43, age M (sd) = 51.8 (17.0), 86.1% female] than suspected COMISA [n = 19, age = 54.0 (14.8), 73.7% female]. There were no between-group differences in baseline questionnaire data, or rates of missing follow-up data. There were no significant group by time interactions on any outcomes. Main effects of time indicated moderate-to-large and sustained improvements in insomnia (d = 3.3), depression (d = 1.2), anxiety (d = 0.6), ESS (d = 0.5), fatigue (d = 1.2), and DBAS-16 symptoms (d = 1.2) at 16-weeks. ESS scores did not increase significantly during any CBTi session.This interactive digital CBTi program is effective in people with insomnia-alone, and people with co-morbid insomnia and high-risk sleep apnea. Further research is required to determine the effectiveness, safety and acceptability of digital CBTi in people with insomnia and confirmed sleep apnea.This trial was prospectively registered on the Australian and New Zealand Clinical Trials Registry (ANZCTR, ACTRN12621001395820).
{"title":"Effect of high-risk sleep apnea on treatment-response to a tailored digital cognitive behavioral therapy for insomnia program: a quasi-experimental trial","authors":"A. Sweetman, C. Reynolds, L. Lack, Andrew Vakulin, C. Chai-Coetzer, Douglas M. Wallace, Megan Crawford, C. Richardson","doi":"10.3389/frsle.2024.1355468","DOIUrl":"https://doi.org/10.3389/frsle.2024.1355468","url":null,"abstract":"Therapist-delivered Cognitive Behavioral Therapy for Insomnia (CBTi) is an effective but largely inaccessible treatment for people with Co-Morbid Insomnia and Sleep Apnea (COMISA). To increase CBTi access for COMISA, we aimed to develop a self-guided interactive 5-session digital CBTi program that is appropriate for people with insomnia-alone and COMISA, and compare its effectiveness between people with insomnia-alone, vs. comorbid insomnia and high-risk sleep apnea.Data from 62 adults with insomnia symptoms were used. High-risk sleep apnea was defined as a score of ≥5 on the OSA50. Participants self-reported symptoms of insomnia (ISI), depression, anxiety, sleepiness (ESS), fatigue, and maladaptive sleep-related beliefs (DBAS-16) at baseline, 8-week, and 16-week follow-up. ESS scores were additionally assessed during each CBTi session. Intent-to-treat mixed models and complete-case chi2 analyses were used.There were more participants with insomnia-alone [n = 43, age M (sd) = 51.8 (17.0), 86.1% female] than suspected COMISA [n = 19, age = 54.0 (14.8), 73.7% female]. There were no between-group differences in baseline questionnaire data, or rates of missing follow-up data. There were no significant group by time interactions on any outcomes. Main effects of time indicated moderate-to-large and sustained improvements in insomnia (d = 3.3), depression (d = 1.2), anxiety (d = 0.6), ESS (d = 0.5), fatigue (d = 1.2), and DBAS-16 symptoms (d = 1.2) at 16-weeks. ESS scores did not increase significantly during any CBTi session.This interactive digital CBTi program is effective in people with insomnia-alone, and people with co-morbid insomnia and high-risk sleep apnea. Further research is required to determine the effectiveness, safety and acceptability of digital CBTi in people with insomnia and confirmed sleep apnea.This trial was prospectively registered on the Australian and New Zealand Clinical Trials Registry (ANZCTR, ACTRN12621001395820).","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140245379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-12DOI: 10.3389/frsle.2024.1383738
Liliana Otero
{"title":"Editorial: Sleep apnea in cardiovascular disease","authors":"Liliana Otero","doi":"10.3389/frsle.2024.1383738","DOIUrl":"https://doi.org/10.3389/frsle.2024.1383738","url":null,"abstract":"","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140250299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-07DOI: 10.3389/frsle.2024.1385793
Henri Korkalainen, Ding Zou
{"title":"Editorial: Novel technologies in the diagnosis and management of sleep-disordered breathing","authors":"Henri Korkalainen, Ding Zou","doi":"10.3389/frsle.2024.1385793","DOIUrl":"https://doi.org/10.3389/frsle.2024.1385793","url":null,"abstract":"","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140260243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-06DOI: 10.3389/frsle.2024.1272726
Preetam Schramm, Emet Schneiderman, Jason Hui, Zohre German, William Stenberg, Ju Ying Lin
Obstructive sleep apnea (OSA) is a multisystem physiological disorder of breathing during sleep that may contribute to systemic physiological imbalances and can also be exacerbated by the use of some commonly prescribed medications.In a randomized parallel design trial, we included phenotypic mild to severe OSA mouth-breathing subjects (n = 36) confirmed by home polygraphy, to evaluate the efficacy of oral appliance plus mouth shield and oral appliance only during sleep on night 1 (T1) after 4 weeks (T2), and after 8 weeks (T3) of oral appliance therapy. Respiratory dynamics data were collected. Primary outcomes were respiratory event index and mouth breathing. Anamnesis on medication intake was collected at enrollment.The respiratory event index and the hypopnea index did not statistically differ between groups at T3. Oral appliance plus mouth shield and oral appliance only significantly reduced mouth breathing at T2 (p = 0.012) and T3 (p ≤ 0.001) compared with baseline. Exploratory analyses showed oral appliance plus mouth shield supine respiratory rate at T3 (p = 0.039) was marginally decreased compared with oral appliance only. The snore percentage did not differ statistically between groups at T3. Oral appliance only showed a marginal oxygen saturation increase (p = 0.019) at T3 compared with oral appliance plus mouth shield. At T3, medication users had persistent respiratory events, mouth breathing, and snoring compared with non-medication users. Logistic regression showed medication use may increase the odds of mouth breathing (OR = 1.148; p = 0.015) and snoring (OR = 1.036; p = 0.049).In our OSA-mouth breathing cohort, oral appliance only was similar to oral appliance plus mouth shield in attenuating the respiratory event index, hypopnea index, and mouth breathing after 8 weeks. Oral appliance only increased oxygen saturation at T3, while oral appliance plus mouth shield maintained a relatively narrow oxygen saturation range from T1–3. Oral appliance plus mouth shield marginally lowered the supine respiratory rate at T3 compared with oral appliance only. Persistent respiratory events, mouth breathing, and snoring were observed in medication users at T3.
阻塞性睡眠呼吸暂停（OSA）是一种多系统的睡眠呼吸生理紊乱，可能导致全身生理失衡，也可能因服用某些常用处方药而加重。在一项随机平行设计试验中，我们纳入了经家庭测谎仪确认的表型为轻度至重度 OSA 的口呼吸受试者（n = 36），以评估在口腔矫治器治疗 4 周后（T2）和 8 周后（T3）的第 1 天晚上（T1）和第 8 天晚上（T3）睡眠时使用口腔矫治器加护口罩和仅使用口腔矫治器的疗效。收集了呼吸动力学数据。主要结果是呼吸事件指数和口呼吸。在 T3 阶段，各组的呼吸事件指数和低通气指数没有统计学差异。与基线相比，口腔矫治器加护口罩组和仅口腔矫治器组在 T2（p = 0.012）和 T3（p ≤ 0.001）时明显减少了口呼吸。探索性分析显示，与仅使用口腔矫治器相比，T3（p = 0.039）时口腔矫治器加护口罩的仰卧呼吸率略有下降。在 T3 阶段，各组的打鼾比例没有统计学差异。与口腔矫治器加口罩组相比，仅使用口腔矫治器组在 T3 阶段的血氧饱和度略有增加（p = 0.019）。在 T3 阶段，与不使用药物的患者相比，使用药物的患者有持续的呼吸事件、口呼吸和打鼾。逻辑回归显示，使用药物可能会增加口呼吸（OR = 1.148; p = 0.015）和打鼾（OR = 1.036; p = 0.049）的几率。在我们的 OSA 口呼吸队列中，仅口腔矫治器与口腔矫治器加口罩在 8 周后减轻呼吸事件指数、低通气指数和口呼吸方面的效果相似。口腔矫治器仅在 T3 阶段提高了血氧饱和度，而口腔矫治器加护口罩则在 T1-3 阶段保持了相对较窄的血氧饱和度范围。与仅使用口腔矫治器相比，口腔矫治器加嘴罩在 T3 阶段略微降低了仰卧呼吸频率。在 T3 阶段，用药者出现了持续呼吸事件、口呼吸和打鼾。
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