CAN META-COGNITIVE OBSERVATION BE USED IN THE TREATMENT OF INSOMNIA? A PILOT STUDY OF A COGNITIVE-EMOTIONAL SELF-OBSERVATION TASK

2002 ◽  
Vol 30 (2) ◽  
pp. 233-236 ◽  
Author(s):  
Lars-Gunnar Lundh ◽  
Henrik Hindmarsh
Keyword(s):  
Pilot Study ◽  
Cognitive Processes ◽  
Sleep Latency ◽  
Total Sleep Time ◽  
Cognitive Activity ◽  
Sleep Time ◽  
Sleep Efficiency ◽  
Sleep Diary ◽  
Control Group

Meta-cognitive observation is a kind of cognitive activity that may serve to interrupt worry, rumination, and other kinds of sleep-interfering cognitive processes. In a pilot study, 40 individuals recorded their sleep on a sleep diary during one week (the baseline week) and were then administered a meta-cognitive observation task to use at bed-time during a second week (“the treatment week”). Consistent with the hypothesis, the participants showed a decreased sleep latency during the treatment week compared to the baseline week, and also an increased total sleep time and an improved sleep efficiency. The lack of a control group (i.e., a group who kept a sleep diary for both weeks, without any meta-cognitive observation task), however, precludes any definite conclusion with regard to the effects of the meta-cognitive observation task. It is suggested that meta-cognitive observation tasks should be tested in controlled studies.

scholarly journals Misperception of sleep in bipolar disorder: an exploratory study using questionnaire versus actigraphy

2020 ◽  
Vol 8 (1) ◽  
Author(s):  
Henrik Myhre Ihler ◽  
Manon Meyrel ◽  
Vincent Hennion ◽  
Julia Maruani ◽  
Gregory Gross ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Obstructive Sleep Apnea ◽  
Sleep Latency ◽  
Total Sleep Time ◽  
Sleep Time ◽  
Sleep Efficiency ◽  
Objective Measures ◽  
Obstructive Sleep

Abstract Background The concept of misperception of sleep refers to the estimated discrepancy between subjective and objective measures of sleep. This has been assessed only in a few prior studies in individuals with Bipolar Disorder (BD) as compared to Healthy Controls (HC) and with mixed results. Methods We assessed a sample of 133 euthymic individuals with BD and 63 HC for retrospective subjective (Pittsburgh Sleep Quality Index) and objective (21 days of actigraphy recording) measures of total sleep time, sleep latency and sleep efficiency. We first investigated the correlations between these subjective and objective measures in the two groups. We then compared individuals with BD and HC for the absolute values of the differences between subjective and objective sleep parameters, used as a proxy of the magnitude of misperception of sleep. Finally, we undertook regression analyses to assess associations between clinical groups, core demographics, clinical factors and misperception of sleep. Results The correlation coefficients between subjective and objective measures of sleep did not differ between groups (total sleep time: rho = .539 in BD and rho = .584 in HC; sleep latency: rho = .190 in BD and rho = .125 in HC; sleep efficiency: rho = .166 in BD and rho = .222 in HC). Individuals with BD did not differ from HC in the magnitude of misperception of total sleep time, sleep latency nor sleep efficiency. Individuals with BD type 1 misperceived their sleep efficiency significantly more than individuals with BD type 2, with no further difference between BD type 1 and BD type 2 regarding sleep latency and sleep duration misperceptions. Three factors (age, symptoms of obstructive sleep apnea, and mild depressive symptoms), were the main contributors to the magnitude of misperception of sleep. Conclusions Misperception of sleep was not associated with a diagnosis of BD. In this sample, mild depressive symptoms, older age, or symptoms of obstructive sleep apnea may be related to greater sleep misperception. In that case, the reliability of subjective measures may decrease as the misperception of sleep increases. This study may help guide clinicians in selecting the best approach for assessing sleep (objective versus subjective measures) in individuals with BD.

Epilepsy and Sleep in the ATR-X Syndrome

2021 ◽  
Author(s):  
Petra van Mierlo ◽  
Hilde Braakman ◽  
Nele Vandenbussche ◽  
Helenius Jurgen Schelhaas ◽  
Sigrid Pillen
Keyword(s):  
Clinical Diagnosis ◽  
Sleep Problems ◽  
Total Sleep Time ◽  
Sleep Time ◽  
Sleep Efficiency ◽  
Sleep Diary ◽  
Cross Sectional ◽  
Eeg Abnormalities ◽  
Epileptic Discharges ◽  
Eeg Recordings

Abstract Background This study explores the prevalence, clinical characteristics, and treatment of epilepsy and sleep disorders in α thalassemia mental retardation (ATR-X) syndrome. Design In this cross-sectional study, 37 participants with ATR-X syndrome aged 1.8 to 44 years were studied using a customized epilepsy questionnaire, review of electroencephalography (EEG) findings, the modified Sleep Questionnaire of Simonds and Parraga and 2-week sleep diary. Results Eleven participants had a clinical diagnosis of generalized epilepsy (29.7%). Seizure types were generalized tonic-clonic seizures, absences, and myoclonia. Interictal EEG recordings in participants with GTCS showed no epileptic discharges in 78%. Similarly, EEG recordings during myoclonia and absences often demonstrated no epileptic discharges. Sleep problems (difficulty falling or maintaining sleep, and early awakening) were reported in 70%. Participants with reported sleep problems went to bed earlier (p = 0.027) and had a lower sleep efficiency (p < 0.01) than participants without sleep problems, but as a group they both had a sufficient total sleep time (9 hours and 52 minutes vs. 10 hours and 55 minutes). Sixteen participants (43.2) used medication to improve sleep (predominantly melatonin n = 10), being effective in only two. Conclusion One-third of participants with ATR-X syndrome had a clinical diagnosis of epilepsy, but the absence of EEG abnormalities in suspected epileptic seizures questions this diagnosis in these patients. EEG recording during seizure like symptoms is warranted before making an epilepsy diagnosis. Seventy percent experienced sleep problems, although total sleep time was normal in most participants. Long bedtimes might have a negative influence on sleep efficiency.

scholarly journals Nighttime Variability in Wrist Actigraphy

2011 ◽  
Vol 19 (2) ◽  
pp. 105-114 ◽  
Author(s):  
Julie L. Otte ◽  
Judith K. Payne ◽  
Janet S. Carpenter
Keyword(s):  
Repeated Measures ◽  
Sleep Disturbances ◽  
Breast Cancer Survivors ◽  
Sleep Latency ◽  
Sleep Onset ◽  
Sleep Time ◽  
Sleep Efficiency ◽  
Sleep Diary ◽  
Repeated Measures Design ◽  
Wrist Actigraphy

Wrist actigraphy measures sleep activity and circadian rhythm. This study examined nighttime variability in Actiwatch parameters in a sample of breast cancer survivors (BCSs) to determine a minimum number of nights needed to obtain an accurate picture of objective sleep. A descriptive, quantitative, and repeated measures design was used. Consenting participants wore an actigraph and completed a sleep diary across 7 nights. There were no significant differences in wake after sleep onset (WASO), total sleep time (TST), sleep latency, or sleep disturbances across nights of week (Monday to Sunday) or monitoring nights (1st to 7th). Sleep efficiency was significantly better at Night 6 compared with Night 7. The coefficients of variation (CVs) for WASO ranged from 46% to 86%, TST 23%–34%, sleep latency 154%–246%, sleep efficiency 12%–22%, and sleep disturbances 33%–41%. Although the CVs indicated high variability across women, there was little internight variability in WASO or TST during across 7 nights of sleep. This suggests that in BCSs, Actiwatch data could be collected and evaluated from any single night for an accurate measure of usual sleep.

scholarly journals Evaluating Sleep Characteristics in Intensive Care Unit and Non-Intensive Care Unit Physicians

2011 ◽  
Vol 39 (6) ◽  
pp. 1071-1075 ◽  
Author(s):  
G. Ok ◽  
H. Yilmaz ◽  
D. Tok ◽  
K. Erbüyün ◽  
S. Çoban ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Shift Work ◽  
Pittsburgh Sleep Quality Index ◽  
Sleep Latency ◽  
Total Sleep Time ◽  
Total Activity ◽  
Sleep Time ◽  
Sleep Parameters ◽  
Icu Physicians

Healthcare workers’ cognitive performances and alertness are highly vulnerable to sleep loss and circadian rhythms. The purpose of this study was to investigate the changes in sleep characteristics of intensive care unit (ICU) and non-ICU physicians. Actigraphic sleep parameters, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale and Hamilton Depression Rating Scale were evaluated for ICU and non-ICU physicians on the day before shift-work and on three consecutive days after shift-work. Total sleep time, sleep latency, wakefulness after sleep onset, total activity score, movement fragmentation index, sleep efficiency, daytime naps and total nap duration were also calculated by actigraph. In the ICU physicians, the mean Pittsburgh Sleep Quality Index score was significantly higher than the non-ICU physicians (P=0.001), however mean Epworth Sleepiness Scale scores were not found significantly different between the two groups. None of the scores for objective sleep parameters were statistically different between the groups when evaluated before and after shift-work (P >0.05). However in both ICU and non-ICU physicians, sleep latency was observed to be decreased within the three consecutive-day period after shift-work with respect to basal values (P <0.001). Total sleep time, total activity score and sleep efficiency scores prior to shift-work were significantly different from shift-work and the three consecutive-days after shift-work, in both groups. Working in the ICU does not have an impact on objective sleep characteristics of physicians in this study. Large cohort studies are required to determine long-term health concerns of shift-working physicians.

scholarly journals Study of correlation between perceived sleep disturbances in depressed patients with objective changes in sleep architecture using polysomnography before and after antidepressant therapy

2020 ◽  
Vol 8 (7) ◽  
pp. 2551
Author(s):  
Ganesh Ingole ◽  
Harpreet S. Dhillon ◽  
Bhupendra Yadav
Keyword(s):  
Sleep Disturbances ◽  
Total Sleep Time ◽  
Antidepressant Treatment ◽  
Sleep Onset ◽  
Sleep Time ◽  
Sleep Efficiency ◽  
Sleep Architecture ◽  
Wake Time ◽  
Depressed Patients ◽  
Before And After

Background: A prospective cohort study to correlate perceived sleep disturbances in depressed patients with objective changes in sleep architecture using polysomnography (PSG) before and after antidepressant therapy.Methods: Patients were recruited into the study after applying strict inclusion and exclusion criterion to rule out other comorbidities which could influence sleep. A diagnosis of Depressive episode was made based on ICD-10 DCR. Psychometry, in the form of Beck Depressive inventory (BDI) and HAMD (Hamilton depression rating scale) insomnia subscale was applied on Day 1 of admission. Patients were subjected to sleep study on Day 03 of admission with Polysomnography. Patients were started on antidepressant treatment post Polysomnography. An adequate trial of antidepressants for 08 weeks was administered and BDI score ≤09 was taken as remission. Polysomnography was repeated post remission. Statistical analysis was performed using Kruskal Wallis test and Pearson correlation coefficient.Results: The results showed positive (improvement) polysomnographic findings in terms of total sleep time, sleep efficiency, wake after sleep onset, percentage wake time and these findings were statistically significant. HAM-D Insomnia subscale was found to correlate with total sleep time, sleep efficiency, wake after sleep onset, total wake time and N2 Stage percentage.Conclusions: Antidepressant treatment effectively improves sleep architecture in Depressive disorder and HAM-D Insomnia subscale correlates with objective findings of total sleep time, sleep efficiency, wake after sleep onset, total wake time and duration of N2 stage of NREM.

scholarly journals A study on sleep apnea in patients with abnormal sewda type of depression

2020 ◽  
pp. 1-8
Author(s):  
Aman Gul ◽  
Nassirhadjy Memtily ◽  
Pirdun Mijit ◽  
Palidan Wushuer ◽  
Ainiwaer Talifu ◽  
...  
Keyword(s):  
Rem Sleep ◽  
Sleep Onset ◽  
Sleep Time ◽  
Sleep Efficiency ◽  
Control Group ◽  
Poor Sleep ◽  
Sleep Structure ◽  
Maintenance Rate ◽  
Sleep Maintenance ◽  
Insomnia Symptoms

Objective: To preliminarily investigate the clinical features and PSG in abnormal sewda-type depressive insomnia. Methods: A total of 127 abnormal sewda-type depressive insomnia patients were evaluated with overnight PSG, and 32 normal participants were compared. Results: Patients with abnormal sewda-type depressive insomnia were compared with the control group; the sleep symptoms showed a long incubation period of sleep, low sleep maintenance rate, low sleep efficiency and poor sleep quality as well as daytime dysfunction. At process and continuity of sleep: Total sleep time, sleep efficiency, sleep maintenance rate in abnormal sewda-type depressive insomnia group were shorter than the control group. Wake after sleep onset, and sleep latency were longer than the control group. At sleep structure: N1 ratio and N2 ratio in depressive insomnia group were longer than the control group, N3 ratio and REM sleep ratio shorter than the control group. At REM index: REM latency, REM cycles, and REM sleep time were shorter than the control group. Conclusion: Insomnia symptoms in abnormal sewda-type depression comorbid insomnia patients were similar to the ordinary insomnia patients. The PSG characteristics had significant changes in sleep process, sleep structure and REM indicators. The severity of the abnormal sewda-type depression was closely related to REM indicators. Change of REM sleep characteristics may be the specificity, and these could be taken as reference in diagnosis and identification of abnormal sewda-type depressive insomnia.

scholarly journals Sleep and Circadian Rhythm Disturbance in Remitted Schizophrenia and Bipolar Disorder: A Systematic Review and Meta-analysis

2020 ◽  
Vol 46 (5) ◽  
pp. 1126-1143 ◽  
Author(s):  
Nicholas Meyer ◽  
Sophie M Faulkner ◽  
Robert A McCutcheon ◽  
Toby Pillinger ◽  
Derk-Jan Dijk ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Circadian Rhythm ◽  
Motor Activity ◽  
Sleep Latency ◽  
Total Sleep Time ◽  
Sleep Time ◽  
Mean Difference ◽  
Effect Sizes ◽  
Time In Bed ◽  
Modifiable Factors

Abstract Background Sleep and circadian rhythm disturbances in schizophrenia are common, but incompletely characterized. We aimed to describe and compare the magnitude and heterogeneity of sleep-circadian alterations in remitted schizophrenia and compare them with those in interepisode bipolar disorder. Methods EMBASE, Medline, and PsycINFO were searched for case–control studies reporting actigraphic parameters in remitted schizophrenia or bipolar disorder. Standardized and absolute mean differences between patients and controls were quantified using Hedges’ g, and patient–control differences in variability were quantified using the mean-scaled coefficient of variation ratio (CVR). A wald-type test compared effect sizes between disorders. Results Thirty studies reporting on 967 patients and 803 controls were included. Compared with controls, both schizophrenia and bipolar groups had significantly longer total sleep time (mean difference [minutes] [95% confidence interval {CI}] = 99.9 [66.8, 133.1] and 31.1 [19.3, 42.9], respectively), time in bed (mean difference = 77.8 [13.7, 142.0] and 50.3 [20.3, 80.3]), but also greater sleep latency (16.5 [6.1, 27.0] and 2.6 [0.5, 4.6]) and reduced motor activity (standardized mean difference [95% CI] = −0.86 [−1.22, −0.51] and −0.75 [−1.20, −0.29]). Effect sizes were significantly greater in schizophrenia compared with the bipolar disorder group for total sleep time, sleep latency, and wake after sleep onset. CVR was significantly elevated in both diagnoses for total sleep time, time in bed, and relative amplitude. Conclusions In both disorders, longer overall sleep duration, but also disturbed initiation, continuity, and reduced motor activity were found. Common, modifiable factors may be associated with these sleep-circadian phenotypes and advocate for further development of transdiagnostic interventions that target them.

scholarly journals 1199 The Accuracy Of A New Sleep Ring Device For Tracking Sleep And Wakefulness Overnight Using Actigraphy

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A458-A459
Author(s):  
H Scott ◽  
N Lovato ◽  
L Lack
Keyword(s):  
Total Sleep Time ◽  
Sleep Time ◽  
Sleep Efficiency ◽  
Tracking Algorithm ◽  
Future Research ◽  
Sleep Laboratory ◽  
Healthy Individuals ◽  
High Agreement ◽  
Additional Funding ◽  
New Consumer

Abstract Introduction THIM is a new consumer ring-like device that can passively monitor sleep overnight using actigraphy. This project aimed to develop the THIM sleep tracking algorithm (Study 1), and test its accuracy against polysomnography (PSG) with another independent sample of good and poor sleepers (Study 2). Methods Study 1: 25 healthy individuals (15 females) aged 25.38 years (SD = 6.39) slept overnight in the sleep laboratory with THIM, the Philips Spectrum, the Fitbit Flex, and PSG recording simultaneously. The THIM sleep tracking algorithm was developed by optimising sensitivity and specificity with PSG. Study 2: An additional 20 individuals (14 females) aged 23.22 years (SD = 5.02) slept overnight in the sleep laboratory with the same devices as in Study 1. Results Study 1: THIM showed high agreement with PSG for estimating sleep (sensitivity = .91) and reasonably high agreement for wakefulness (specificity = .59). There were no significant differences between PSG and THIM for total sleep time, t(24) = 0.76, p = .46, or sleep efficiency, t(24) = 0.56, p = .58. Study 2: THIM showed high agreement with PSG for estimating sleep (sensitivity = .89) and wakefulness (specificity = .59). Compared to PSG, THIM significantly underestimated total sleep time, t(19) = 2.10, p = .049, and sleep efficiency, t(19) = 2.20, p = .04, by an average of 21.35 minutes (SD = 45.52) and 4.44% (SD = 9.04), respectively. Conclusion Together, these studies suggest that THIM is reasonably accurate for monitoring sleep overnight in healthy individuals. Slight modifications to the algorithm and additional sensors could be added to THIM to improve its accuracy. Future research will examine the accuracy of THIM with larger sample sizes and particularly for people with insomnia, with the goal being to incorporate sleep tracking into a mobile-based treatment program for insomnia. Support The project was funded in-part by the manufacturers of THIM, Re-Time Pty. Ltd. Additional funding was provided by Flinders University.

A Comparative Study of Sleep and Mood Between Young Elite Athletes and Age-Matched Controls

2017 ◽  
Vol 14 (6) ◽  
pp. 465-473 ◽  
Author(s):  
Anette Harris ◽  
Hilde Gundersen ◽  
Pia Mørk Andreassen ◽  
Eirunn Thun ◽  
Bjørn Bjorvatn ◽  
...  
Keyword(s):  
Physical Activity ◽  
Total Sleep Time ◽  
Elite Athletes ◽  
Sleep Onset ◽  
Sleep Time ◽  
Sleep Diary ◽  
Sleep Onset Latency ◽  
Onset Latency ◽  
Social Jetlag ◽  
Weekly Training

Background:Sleep and mood have seldom been compared between elite athletes and nonelite athletes, although potential differences suggest that physical activity may affect these parameters. This study aims to explore whether adolescent elite athletes differ from controls in terms of sleep, positive affect (PA) and negative affect (NA).Methods:Forty-eight elite athletes and 26 controls participating in organized and nonorganized sport completed a questionnaire, and a 7-day sleep diary.Results:On school days, the athletes and the controls who participated in organized and nonorganized sport differed in bedtime (22:46, 23:14, 23:42, P < .01), sleep onset (23:03, 23:27, 00:12, P < .01), and total sleep time (7:52, 8:00, 6:50, P < 01). During weekend, the athletes, the controls who participated in organized and nonorganized sport differed in bedtime (23:30, 00:04, 00:49, P < .01), sleep onset (23.42, 00:18, 01:13, P < .01), rise time (9:15, 9:47, 10:55, P < .01), sleep efficiency (95.0%, 94.2%, 90.0%, P < 05), and sleep onset latency (11.8, 18.0, 28.0 minutes, P < .01). Furthermore, the athletes reported less social jetlag (0:53) and higher score for PA (34.3) compared with the controls who participated in nonorganized sport (jetlag: 1:25, P < .05, PA: 29.8, P < .05).Conclusions:An almost dose-response association was found between weekly training hours, sleep, social jetlag and mood in adolescents.

Testing the contiguity of the sleep and fatigue relationship: a daily diary study

SLEEP ◽  
2020 ◽  
Author(s):  
Andrea L Harris ◽  
Nicole E Carmona ◽  
Taryn G Moss ◽  
Colleen E Carney
Keyword(s):  
Sleep Quality ◽  
Hierarchical Linear Modeling ◽  
Total Sleep Time ◽  
Sleep Time ◽  
Cognitive Factors ◽  
Sleep Diary ◽  
Poor Sleep ◽  
Daily Diary Study ◽  
Insomnia Disorder ◽  
The Relationship

Abstract Study Objectives There is mixed evidence for the relationship between poor sleep and daytime fatigue, and some have suggested that fatigue is simply caused by lack of sleep. Although retrospective measures of insomnia and fatigue tend to correlate, other studies fail to demonstrate a link between objectively disturbed sleep and fatigue. The current study prospectively explored the relationship between sleep and fatigue among those with and without insomnia disorder. Methods Participants meeting Research Diagnostic Criteria for insomnia disorder (n = 33) or normal sleepers (n = 32) completed the Consensus Sleep Diary (CSD) and daily fatigue ratings for 2 weeks. Baseline questionnaires evaluated cognitive factors including unhelpful beliefs about sleep and rumination about fatigue. Hierarchical linear modeling tested the within- and between-participant relationships between sleep quality, total sleep time, and daily fatigue ratings. Mediation analyses tested if cognitive factors mediated the relationship between insomnia and fatigue. Results Self-reported nightly sleep quality significantly predicted subsequent daily fatigue ratings. Total sleep time was a significant predictor of fatigue within, but not between, participants. Unhelpful sleep beliefs and rumination about fatigue mediated the relationship between insomnia and fatigue reporting. Conclusions The results suggest that perception of sleep plays an important role in predicting reports of daytime fatigue. These findings could be used in treatment to help shift the focus away from total sleep times, and instead, focus on challenging maladaptive sleep-related cognitions to change fatigue perception.

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