1036 Does Diary and Actigraphy Measured Sleep Differ Between Good and Poor Sleepers During Breast Cancer Treatment?

Abstract Introduction Women may enter in breast cancer (BCa) treatment with poor sleep, or it may begin during treatment. We assessed how subjective and objective sleep changes during the first year of treatment for women with BCa. Further, we examined whether this differs between previously good and poor sleepers and whether there was agreement between subjective and objective measures of sleep. Methods Sleep onset latency (SOL), wake after sleep onset (WASO), total sleep time (TST), and sleep efficiency (SE) were measured among 100 patients with newly diagnosed, non-metastatic BCa using 7 days of diary and actigraphy collected at 4 time points: pre-treatment, 4, 8, and 12 months. Women with a score ≥5 on the Pittsburgh Sleep Quality Index at treatment onset were classified as poor sleepers. A 4 (time: 0-, 4-, 8-, 12-months) by 2 (sleep measure: sleep diary, actigraphy) by 2 (group: good, poor sleepers) mixed model ANOVAs was performed for each sleep parameter. Results There was a time by sleep measure by group interaction for TST, [F(3,294)= 3.014, p = .03). Good sleepers reported greater TST on diaries- than actigraphy at pre-treatment and 12 months, whereas there were no differences in poor sleepers. There was a group by time effect for good vs. poor sleepers [F(3,294)= 2.909, p = .035]. Good sleepers experienced decreased TST and SE from pre-treatment through 4-mo, followed by increases. Poor sleepers showed the opposite pattern. Neither group returned to pre-treatment levels. Sleep diaries and actigraphy are concordant over time for TST, but not SOL, WASO, or SE. Conclusion Sleep parameters worsen during the first year following onset of BCa and concordance between sleep diaries and actigraphy differ between good or poor sleepers. Support Dr. Garland is supported by a Scotiabank New Investigator Award and seed funding from the Beatrice Hunter Cancer Research Institute (BHCRI).

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0519 Mindfulness Based Therapy for Insomnia Improves Objective Markers of Sleep in the Elderly: Preliminary Data from the Mindfulness Sleep Therapy (MIST) Study

SLEEP ◽

10.1093/sleep/zsaa056.516 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A198-A199

Author(s):

K F Wong ◽

F Perini ◽

S L Henderson ◽

J Teng ◽

Z Hassirim ◽

...

Keyword(s):

Preliminary Data ◽

Repeated Measures ◽

Mixed Model ◽

Controlled Trial ◽

Sleep Onset ◽

Sleep Diary ◽

Control Group ◽

Poor Sleep ◽

Sleep Onset Latency ◽

Time In Bed

Abstract Introduction Mindfulness-based treatment for insomnia (MBTI) is a viable intervention for improving poor sleep. We report preliminary data from an ongoing pre-registered, randomized controlled trial which investigates the effect of MBTI on elderly adults. Methods Participants above 50 years old with PSQI ≥ 5 were recruited and randomised into either MBTI or an active control group (Sleep hygiene education and exercise program, SHEEP) in sequential cohorts with about 20 participants per cohort (10 per group). Before and after the intervention, 1 night of portable polysomnography (PSG) and 1 week of actigraphy (ACT) and sleep diary (DIARY) data were collected. We report the ACT and DIARY results of the first 3 cohorts (n = 46, male = 23, mean age = 62.3, std = 6.3) and PSG data of the first 2 cohorts (n = 29, male = 12, mean age = 62.5, std = 5.7). Time in bed (TIB), total sleep time (TST), sleep onset latency (SOL), wake after sleep onset (WASO), and sleep efficiency (SE) were analysed with mixed-model repeated-measures ANOVA. Results We observed increases in TIBDIARY (F1,44 = 5.151, p < .05) and SEDIARY (F1,44 = 22.633, p < .0001), and significant reductions in SOLDIARY (F1,44 = 7.031, p < .05) and WASODIARY (F1,39 = 7.411, p < .05). In the actigraphy data, we found a significant interaction in SOLACT (F1,39 = 4.273, p < .05) with an increase in SHEEP SOLACT (t18= 2.36, p < .05). Significant reductions were also observed in WASOACT (F1,44 = 16.459, p < .0001) Finally, we observed a reduction in SOLPSG (F1,26 = 5.037, p <. 05). All other tests were non-significant. Conclusion Preliminary results suggest that both interventions lead to improvements in sleep with more pronounced effects in subjective sleep reports. Objective sleep data suggest that improvements in sleep is a result of improved sleep quality and not simply extending sleep opportunity. These preliminary data shows that MBTI may be a promising intervention for elderly individuals with sleep difficulties. Support This study was supported by an award from the 7th grant call of the Singapore Millennium Foundation Research Grant Programme

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The Cycle of Daily Stress and Sleep: Sleep Measurement Matters

Annals of Behavioral Medicine ◽

10.1093/abm/kaaa053 ◽

2020 ◽

Author(s):

Danica C Slavish ◽

Justin Asbee ◽

Kirti Veeramachaneni ◽

Brett A Messman ◽

Bella Scott ◽

...

Keyword(s):

Sleep Disturbances ◽

Multilevel Models ◽

Single Channel ◽

Sleep Onset ◽

Sleep Time ◽

Sleep Diary ◽

Sleep Onset Latency ◽

Daily Stress ◽

Sleep Diaries ◽

Sleep Measurement

Abstract Background Disturbed sleep can be a cause and a consequence of elevated stress. Yet intensive longitudinal studies have revealed that sleep assessed via diaries and actigraphy is inconsistently associated with daily stress. Purpose We expanded this research by examining daily associations between sleep and stress using a threefold approach to assess sleep: sleep diaries, actigraphy, and ambulatory single-channel electroencephalography (EEG). Methods Participants were 80 adults (mean age = 32.65 years, 63% female) who completed 7 days of stressor and sleep assessments. Multilevel models were used to examine bidirectional associations between occurrence and severity of daily stress with diary-, actigraphy-, and EEG-determined sleep parameters (e.g., total sleep time [TST], sleep efficiency, and sleep onset latency, and wake after sleep onset [WASO]). Results Participants reported at least one stressor 37% of days. Days with a stressor were associated with a 14.4-min reduction in actigraphy-determined TST (β = −0.24, p = 0.030), but not with other actigraphy, diary, or EEG sleep measures. Nights with greater sleep diary-determined WASO were associated with greater next-day stressor severity (β = 0.01, p = 0.026); no other diary, actigraphy, or EEG sleep measures were associated with next-day stressor occurrence or severity. Conclusions Daily stress and sleep disturbances occurred in a bidirectional fashion, though specific results varied by sleep measurement technique and sleep parameter. Together, our results highlight that the type of sleep measurement matters for examining associations with daily stress. We urge future researchers to treat sleep diaries, actigraphy, and EEG as complementary—not redundant—sleep measurement approaches.

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0524 Web-Delivered CBT for Insomnia Intervention Improves Sleep Among Adults with Insomnia and Depressive Symptoms

SLEEP ◽

10.1093/sleep/zsaa056.521 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A200-A201

Author(s):

P J Batterham ◽

H Christensen ◽

F P Thorndike ◽

L M Ritterband ◽

R Gerwien ◽

...

Keyword(s):

Depressive Symptoms ◽

Sleep Quality ◽

Large Scale ◽

Behavioral Therapy ◽

Controlled Trial ◽

Sleep Onset ◽

Sleep Diary ◽

Sleep Onset Latency ◽

Sleep Diaries

Abstract Introduction Cognitive behavioral therapy for insomnia (CBT-I) is the first line recommended treatment for adults with chronic insomnia. In a prior randomized controlled trial (RCT), data showed web-delivered CBT-I (SHUTi) reduced insomnia severity as well as symptoms of depression, among adults with insomnia and elevated depressive symptoms. The present study aimed to further evaluate the effectiveness of web CBT-I to improve sleep outcomes as measured by prospectively entered sleep diaries in this same sample. Methods A large-scale RCT (N=1149) of Australian adults with insomnia and depressive symptoms compared a 9-week, web CBT-I therapeutic with an attention-matched web program at baseline, posttest and 6-, 12-, and 18-month follow-ups. Although depression outcomes have been presented previously, the online sleep-diary derived variables have not yet been presented, including sleep-onset latency (SOL), wake after sleep onset (WASO), sleep efficiency (SE), number of awakenings, sleep quality, and total sleep time (TST). Sleep diaries were entered online for 10 days at each assessment period. Results Data showed web CBT-I participants demonstrated greater reductions from baseline to posttest compared with control for the following sleep variables: SOL (LS mean difference [95% CI]=-22.3 min [-29.2, -15.3]; p<.0001), WASO (-17.8 min [-23.4, -12.3]; p<.0001), and number of awakenings (-0.38 [-0.68, -0.09]; p=.0113). Web CBT-I also showed greater improvements in SE (9.18% [7.25%, 11.10%]; p<.0001) and sleep quality (0.41 [0.30, 0.53]; p<.0001) from baseline to posttest compared with control. TST was not significantly different between groups at posttest or 6-month follow-up, although it improved over baseline at 12 (18.73 min [7.39, 30.07]; p=.0013) and 18 months (23.76 min [9.15, 38.36]; p=.0015) relative to control. All other significant sleep treatment effects were maintained in the treatment arm at 6, 12, and 18-month follow-up. Conclusion Data showed web CBT-I produced lasting improvements in sleep outcomes among adults with insomnia and elevated depressive symptoms. Support Clinical trial ACTRN12611000121965 was funded by the Australian National Health and Medical Research Council. The statistical analysis described here was funded by Pear Therapeutics, Inc and conducted by Provonix.

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Sleep Related Beliefs and their Association with Alcohol Relapse Following Residential Alcohol Detoxification Treatment

Behavioural and Cognitive Psychotherapy ◽

10.1017/s1352465813000465 ◽

2013 ◽

Vol 42 (5) ◽

pp. 593-604 ◽

Cited By ~ 13

Author(s):

Neil Smith ◽

Robert Hill ◽

Jane Marshall ◽

Francis Keaney ◽

Shamil Wanigaratne

Keyword(s):

Alcohol Dependence ◽

Sleep Problems ◽

Sleep Onset ◽

Poor Sleep ◽

Inpatient Setting ◽

Sleep Onset Latency ◽

Dysfunctional Beliefs ◽

Sleep Diaries ◽

Relapse Rates ◽

Dysfunctional Beliefs About Sleep

Background: Alcohol dependence is known to impact upon sleep, and poor sleep has been shown to affect relapse rates following treatment for alcohol dependence. Aims: The aim of this study was to investigate the association between sleep problems and relapse in dependent drinkers in an inpatient setting. This was done by studying sleep related cognitions in individuals undergoing medically assisted alcohol withdrawal. Method: Sleep and sleep-related cognitions data were collected for 71 individuals undergoing detoxification treatment. Sleep was measured using sleep diaries and actigraph motion monitors. Participants completed sleep-related cognition questionnaires and were subject to telephone follow-up interviews. The results were then used to predict relapse rates 4 weeks after discharge. Results: Longer sleep onset latency recorded on the unit predicted relapse at 4 weeks. Higher dysfunctional beliefs about sleep were found to be associated with lower relapse rates. Conclusions: This study suggests that some dysfunctional beliefs about sleep may support recovery following discharge from treatment. The study further supports the need for tailored cognitive-behavioural treatments for sleep difficulties in this population to reduce relapse rates.

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Considering Sleep, Mood, and Stress in a Family Context: A Preliminary Study

Clocks & Sleep ◽

10.3390/clockssleep1020022 ◽

2019 ◽

Vol 1 (2) ◽

pp. 259-272 ◽

Cited By ~ 2

Author(s):

Valeria Bacaro ◽

Bernd Feige ◽

Andrea Ballesio ◽

Paola De Bartolo ◽

Anna F. Johann ◽

...

Keyword(s):

Sleep Quality ◽

Gender Gap ◽

Negative Mood ◽

Family Members ◽

Sleep Onset ◽

Poor Sleep ◽

Sleep Onset Latency ◽

Mothers And Fathers ◽

Sleep Diaries ◽

Lack Of Sleep

Background: During the first years of life, parental sleep strongly depends on child’s sleep quality. Poor parental sleep may relate to increased stress and negative mood. However, there is a lack of sleep studies focusing on all family members. This study aimed to investigate the relationship between sleep, mood, and stress in mothers, fathers and children. Methods: Data were obtained from 65 parental couples and 65 children (2 to 36 months). Data on sleep for all family members and stress of parents were completed by both mothers and fathers through questionnaires and sleep diaries. Results: Toddlers’ positive mood before nocturnal sleep was significantly associated with reduced wake times after sleep onset. Mothers reported worse sleep quality compared to fathers. Shorter sleep onset latency in fathers and better sleep efficiency in mothers were linked with better self-reported mood upon awakening. In mothers, but not in fathers, poor sleep quality was associated with higher perceived stress. Conclusion: Results suggest bidirectional relationships between sleep and mood in children, mothers and fathers. Moreover, results evidence poorer sleep in mothers, compared to fathers, which was linked with increased parenting stress. This gender gap should be further considered in studies with larger samples and in clinical contexts.

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0178 The Cycle of Daily Stress and Sleep: Sleep Measurement Matters

SLEEP ◽

10.1093/sleep/zsaa056.176 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A70-A71

Author(s):

D C Slavish ◽

J Asbee ◽

K Veeramachaneni ◽

B Messman ◽

B Scott ◽

...

Keyword(s):

Sleep Disturbances ◽

Multilevel Models ◽

Single Channel ◽

Sleep Onset ◽

Sleep Diary ◽

Sleep Onset Latency ◽

Daily Stress ◽

Sleep Diaries ◽

Sleep Parameters ◽

Sleep Measurement

Abstract Introduction Disturbed sleep can be both a cause and a consequence of increased stress. Yet intensive longitudinal studies have demonstrated that sleep assessed via sleep diaries and actigraphy is inconsistently associated with daily stress. We expanded this research by examining daily associations between sleep and stress using a three-fold approach to assess sleep: sleep diaries, actigraphy, and ambulatory single-channel electroencephalography [EEG]. Methods Participants were 80 adults (M age = 32.65 years, 63% female) who completed 7 days of sleep and perceived stress assessments in a naturalistic setting (resulting in 560 possible measurement occasions). Multilevel models were used to examine bidirectional associations between daily stressor occurrence (0 = stressor did not occur, 1 = stressor occurred) and stressor severity (0 = not at all severe to 3 = very severe) and sleep parameters assessed via diary, actigraphy, and EEG (e.g. total sleep time [TST], sleep efficiency [SE], and sleep onset latency [SOL], wake after sleep onset [WASO]). Results Participants reported at least one stressor on 37% of days. Compared to days without a stressor experienced, days with a stressor were associated with a 14.4-minute reduction in actigraphy-determined TST the subsequent night (β = -0.24, p = 0.030). Nights with greater sleep-diary determined WASO were associated with greater next-day stressor severity (β = 0.01, p = .026). No EEG-determined sleep parameters were associated with next-day stressor occurrence or severity, or vice versa. Conclusion Daily stress and sleep disturbances occurred in a bidirectional fashion, though specific results varied by sleep measurement technique and sleep parameter. Together, our results highlight that type of sleep measurement matters for examining associations with daily stress. We urge future researchers to treat sleep diaries, actigraphy, and EEG as complementary — not redundant — sleep measurement approaches. Support Funding for this study included NIH/NIAID R01AI128359-01; DoD-VA 1I01CU000144-01; the Foundation for Rehabilitation Psychology; and General Sleep Corporation.

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Comparison of single-channel EEG, actigraphy, and sleep diary in cognitively normal and mildly impaired older adults

SLEEP Advances ◽

10.1093/sleepadvances/zpaa006 ◽

2020 ◽

Vol 1 (1) ◽

Author(s):

Chris A Chou ◽

Cristina D Toedebusch ◽

Tiara Redrick ◽

David Freund ◽

Jennifer S McLeland ◽

...

Keyword(s):

Older Adults ◽

Sleep Disturbances ◽

Single Channel ◽

Sleep Onset ◽

Amyloid Β ◽

Sleep Diary ◽

Sleep Onset Latency ◽

Cognitively Normal ◽

Sleep Diaries ◽

Sleep Parameters

Abstract Study Objectives Multiple methods for monitoring sleep-wake activity have identified sleep disturbances as risk factors for Alzheimer disease (AD). In order to identify the level of agreement between different methods, we compared sleep parameters derived from single-channel EEG (scEEG), actigraphy, and sleep diaries in cognitively normal and mildly impaired older adults. Methods Two hundred ninety-three participants were monitored at home for up to six nights with scEEG, actigraphy, and sleep diaries. Total sleep time (TST), sleep efficiency (SE), sleep onset latency (SOL), and wake after sleep onset (WASO) were calculated using each of these methods. In 109 of the 293 participants, the ratio of cerebrospinal fluid concentrations of phosphorylated tau (p-tau) and amyloid-β-42 (Aβ42) was used as a biomarker for AD pathology. Results Agreement was highest for TST across instruments, especially in cognitively normal older adults. Overall, scEEG and actigraphy appeared to have greater agreement for multiple sleep parameters than for scEEG and diary or actigraphy and diary. Levels of agreement between scEEG and actigraphy overall decreased in mildly impaired participants and those with biomarker evidence of AD pathology, especially for measurements of TST. Conclusions Caution should be exercised when comparing scEEG and actigraphy in individuals with mild cognitive impairment or with AD pathology. Sleep diaries may capture different aspects of sleep compared to scEEG and actigraphy. Additional studies comparing different methods of measuring sleep-wake activity in older adults are necessary to allow for comparison between studies using different methods.

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The Development of a Sleep Intervention for Firefighters: The FIT-IN (Firefighter’s Therapy for Insomnia and Nightmares) Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17238738 ◽

2020 ◽

Vol 17 (23) ◽

pp. 8738

Author(s):

Eun Hee Jang ◽

Yujin Hong ◽

Yeji Kim ◽

Sangha Lee ◽

Yeonsoon Ahn ◽

...

Keyword(s):

Sleep Disturbance ◽

Sleep Onset ◽

Severity Index ◽

Sleep Diary ◽

Sleep Onset Latency ◽

Post Intervention ◽

Sleep Diaries ◽

Imagery Rehearsal Therapy ◽

Time In Bed ◽

Fire Stations

Background: Firefighters are vulnerable to irregular sleep patterns and sleep disturbance due to work characteristics such as shift work and frequent dispatch. However, there are few studies investigating intervention targeting sleep for firefighters. This preliminary study aimed to develop and test a sleep intervention, namely FIT-IN (Firefighter’s Therapy for Insomnia and Nightmares), which was based on existing evidence-based treatment tailored to firefighters in consideration of their occupational characteristics. Methods: This study implemented a single-group pre-post study design, utilizing an intervention developed based on brief behavior therapy for insomnia with imagery rehearsal therapy components. FIT-IN consisted of a total of three sessions (two face-to-face group sessions and one telephone session). Participants were recruited from Korean fire stations, and a total of 39 firefighters participated. Participants completed a sleep diary for two weeks, as well as the following questionnaires to assess their sleep and psychological factors: insomnia severity index (ISI), disturbing dream and nightmare severity index (DDNSI), Epworth sleepiness scale (ESS), depressive symptom inventory-suicidality subscale (DSI), and Patient Health Questionnaire-9 (PHQ-9). These questionnaires were administered before the first session and at the end of the second session. Results: The FIT-IN program produced improvements in sleep indices. There was a significant increase in sleep efficiency (p < 0.01), and a decrease in sleep onset latency, number of awakenings, and time in bed (p < 0.05), as derived from weekly sleep diaries. In addition, significant decreases were shown for insomnia (p < 0.001) and nightmare severity (p < 0.01). Conclusion: There were significant improvements in sleep and other clinical indices (depression, PTSD scores) when comparing pre-and post-intervention scores. FIT-IN may be a feasible and practical option in alleviating sleep disturbance in this population. Further studies will be needed to ascertain FIT-IN’s effectiveness.

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Mindfulness and Behaviour Therapy for Insomnia: An Assessment of Treatment Effect in a Sleep Disorders Clinic Population with Insomnia

Behaviour Change ◽

10.1017/bec.2020.18 ◽

2020 ◽

pp. 1-15

Author(s):

Allie Peters ◽

John Reece ◽

Hailey Meaklim ◽

Moira Junge ◽

David Cunnington ◽

...

Keyword(s):

Sleep Disorders ◽

Treatment Effect ◽

Sleep Onset ◽

Sleep Efficiency ◽

Health Concern ◽

Sleep Diary ◽

Sleep Onset Latency ◽

Subjective Sleep ◽

Sleep Parameters

Abstract Insomnia is a common major health concern, which causes significant distress and disruption in a person's life. The objective of this paper was to evaluate a 6-week version of Mindfulness-Based Therapy for Insomnia (MBTI) in a sample of people attending a sleep disorders clinic with insomnia, including those with comorbidities. Thirty participants who met the DSM-IV-TR diagnosis of insomnia participated in a 6-week group intervention. Outcome measures were a daily sleep diary and actigraphy during pre-treatment and follow-up, along with subjective sleep outcomes collected at baseline, end-of-treatment, and 3-month follow-up. Trend analyses showed that MBTI was associated with a large decrease in insomnia severity (p < .001), with indications of maintenance of treatment effect. There were significant improvements in objective sleep parameters, including sleep onset latency (p = .005), sleep efficiency (p = .033), and wake after sleep onset (p = .018). Significant improvements in subjective sleep parameters were also observed for sleep efficiency (p = .005) and wake after sleep onset (p < .001). Overall, this study indicated that MBTI can be successfully delivered in a sleep disorders clinic environment, with evidence of treatment effect for both objective and subjective measures of sleep.

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778 Poor Sleep Quality is Associated with Reduced Myelination in Patients with Psychotic Disorders

SLEEP ◽

10.1093/sleep/zsab072.775 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A303-A303

Author(s):

Cagri Yuksel ◽

Xi Chen ◽

Lauren Watford ◽

Margaret Gardner ◽

Kathryn Lewandowski ◽

...

Keyword(s):

White Matter ◽

Sleep Quality ◽

Psychotic Disorders ◽

Sleep Onset ◽

Sleep Loss ◽

Magnetization Transfer Ratio ◽

Poor Sleep ◽

Sleep Onset Latency ◽

Healthy Controls ◽

Poor Sleep Quality

Abstract Introduction Recent studies show that sleep favors oligodendrocyte proliferation and myelination, and sleep loss is associated with alterations in white matter structure and decreased myelination. Psychotic disorders are characterized by disrupted white matter integrity, and abnormal axon and myelin structure. Despite common sleep disturbances in these disorders, little is known about the relationship between sleep quality and white matter findings. A novel in vivo neuroimaging technique that combines diffusion tensor spectroscopy (DTS) and magnetization transfer ratio (MTR) allows separately examining the axon structure and glial function, and myelin content, respectively. Using this method, we examined the association of sleep quality with white matter biology in a sample of patients with psychotic disorders and matched healthy controls. Methods Participants included patients diagnosed with bipolar disorder with psychotic features (euthymic or depressed, n=12) and schizophrenia spectrum disorders (n=9), and age and sex matched healthy controls (n=20). DTS and MTR data was collected from the right prefrontal white matter at 4T. DTS measures included apparent diffusion coefficients of water, NAA, creatine and choline. Sleep quality was measured using Pittsburgh Sleep Quality Index (PSQI). Results PSQI total score was significantly higher in patients. and patient sample included a higher percentage of poor sleepers (PSQI total score>5). In patients, total PSQI score and sleep onset latency were significantly and negatively associated with MTR (F=6.9, p=0.02 and F=9.7, p=0.007, respectively). There was no difference in any DTS measures between groups. Conclusion Our preliminary results show that poor sleep quality is associated with decreased myelin content in the frontal lobe, in patients with psychotic disorders. This finding suggests that sleep loss may be a mediator of white matter alterations in psychosis. Support (if any) This work is supported by National Institute of Mental Health K23MH119322 to Cagri Yuksel

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