scholarly journals 1108 Associations Between Insomnia And Anxiety Symptoms: Which Elements Of Insomnia Are Associated With Which Elements Of Anxiety?

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A421-A422
Author(s):  
A Kapoor ◽  
M L Perlis ◽  
C Bastien ◽  
N Williams ◽  
L Hale ◽  
...  
Keyword(s):  
Severity Index ◽  
Anxiety Symptoms ◽  
Anxiety Level ◽  
Future Research ◽  
Loss Of Control ◽  
Regression Analyses ◽  
Race Ethnicity ◽  
Healthy Activity ◽  
Insomnia Severity ◽  
Anxiety Questionnaire

Abstract Introduction It is still not clear which aspects of insomnia are associated with various aspects of anxiety problems. Knowing this could better guide treatment of insomnia comorbid with anxiety. Methods Data from the Sleep and Healthy Activity, Diet, Environment, and Socialization (SHADES) study were used, including N=1003 adults age 22-60. All participants completed the Insomnia Severity Index (ISI) and the GAD7 anxiety questionnaire. The ISI was divided into 3 sections, based on prior work: SLEEP symptoms (difficulty sleeping), DAYTIME symptoms (difficulty functioning), and PERCEPTION symptoms (dissatisfaction). GAD7 items included anxiety level, loss of control, worry about many things, difficulty relaxing, restlessness, irritability, and fear. Logistic regression analyses examined each symptom, with each component of the ISI as predictor, as well as age, sex, race/ethnicity and education as covariates. Results SLEEP symptoms were independently associated with control (OR=1.09, p=0.03), many worries (OR=1.1, p=0.017), restlessness (OR=1.1, p=0.009), and irritability (OR=1.1, p=0.04). DAYTIME symptoms were independently associated with anxiety level (OR=1.3, p<0.0005), control (OR=1.2, p<0.0005), many worries (OR=1.3, p<0.0005), difficulty relaxing (OR=1.2, p=0.004), restlessness (OR=1.3, p=0.001), and irritability (OR=1.2, p<0.0005). PERCEPTION symptoms were uniquely, independently associated with anxiety level (OR=1.1, p=0.03), control (OR=1.2, p=0.001), many worries (OR=1.2, p=0.001), difficulty relaxing (OR=1.4, p<0.0005), irritability (OR=1.2, p=0.018), and feelings of fear (OR=1.2, p=0.002). Conclusion The DAYTIME and PERCEPTION symptoms of insomnia were strongly related to anxiety symptoms. Current treatments for insomnia focus mainly on improving sleep. Future research should test the hypothesis that treating daytime symptoms of insomnia may aid patients with comorbid anxiety. Support The SHADES study was funded by R21ES022931. Dr. Grandner is supported by R01MD011600.

381 Evening Chronotype Predicts Subjective Sleep Symptom Severity in Pregnant Women with Insomnia Disorder

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A151-A151
Author(s):  
Joshua Tutek ◽  
Natalie Solomon ◽  
Jessica Dietch ◽  
Norah Simpson ◽  
Rachel Manber
Keyword(s):  
Pregnant Women ◽  
Behavioral Therapy ◽  
Stress Test ◽  
Severity Index ◽  
Future Research ◽  
Composite Scale ◽  
Insomnia Disorder ◽  
Early Postpartum ◽  
Gestational Week ◽  
Insomnia Severity

Abstract Introduction Evening chronotype is associated with greater reports of insufficient sleep and sleep-related distress. Little research has examined this relationship within the context of pregnancy. This study investigated whether eveningness predicts insomnia severity, sleep effort, dysfunctional sleep beliefs, and sleep reactivity to stress in pregnant women with insomnia disorder. Methods Pregnant women with insomnia disorder who spoke English or Spanish enrolled in a clinical trial of cognitive behavioral therapy for insomnia (N = 178; M age = 32.6 years). Before beginning treatment, participants completed the Composite Scale of Morningness (CSM), Insomnia Severity Index (ISI), Glasgow Sleep Effort Scale (GSS), Dysfunctional Beliefs and Attitudes about Stress Scale (DBAS), and Ford Insomnia Response to Stress Test (FIRST). Participants were categorized into evening, intermediate, or morning chronotypes (bottom 25%, middle 50%, or top 25% of CSM scores, respectively). MANCOVA examined whether chronotype predicted higher baseline ISI, GSS, DBAS, and FIRST scores after adjusting for age, gestational week of pregnancy, and language. Results Sleep measures collectively differed by chronotype, F(8, 336) = 4.05, p < .001; Wilk’s Λ = .83, partial η-sqd = .09. Follow-up ANOVAs testing individual dependent variables were all significant (partial η-sqd = .04 – .10, p < .05). Pairwise comparisons (Bonferroni-adjusted; p < .05) found that evening types had higher ISI scores than intermediate (M difference = 2.21) and morning types (M difference = 2.30), and higher DBAS scores than morning types (M difference = .95). Morning types had lower FIRST scores than evening (M difference = 5.44) and intermediate types (M difference = 3.89). Conclusion Evening chronotype was associated with greater insomnia severity and maladaptive sleep-related cognition than other chronotypes among pregnant women with insomnia disorder. Future research may examine whether differences in chronotype have implications for insomnia treatment outcome during pregnancy, and whether greater morningness confers protection against sleep challenges during the early postpartum period. Support (if any) NIH R01 NR013662

774 Insomnia precedes suicidal ideation in a national longitudinal study of sleep continuity (NITES)

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A301-A301
Author(s):  
Andrew Tubbs ◽  
Knashawn Morales ◽  
Michael Grandner ◽  
Jason Ellis ◽  
Ivan Vargas ◽  
...  
Keyword(s):  
Suicidal Ideation ◽  
Suicide Risk ◽  
Severity Index ◽  
Sleep Time ◽  
Wake Time ◽  
Sleep Diaries ◽  
Sleep Continuity ◽  
Race Ethnicity ◽  
Suicidal Thoughts And Behaviors ◽  
Insomnia Severity

Abstract Introduction Suicide is the 10th leading cause of death among US adults, and disrupted sleep significantly increases suicide risk. It is unclear, however, how quickly changes in sleep can affect suicidal thoughts and behaviors. Therefore, the present study explored whether insomnia, sleep continuity, and nightmares predicted subsequent suicidal thinking. Methods Data were drawn from N=1,248 individuals 35 years and older who were part of a 1-year prospective study of the natural history of insomnia. Suicidal ideation was measured biweekly from the Patient Health Questionnaire – 9 and dichotomized (Score = 0, No; Score > 0, Yes). The primary predictors were Insomnia Severity Index (ISI) score and total wake time, total sleep time, difficulty initiating/maintaining sleep, and nightmares (from daily sleep diaries). Predictors were averaged over the previous 2 weeks and measured 2 nights prior to measuring suicidal ideation. Data were modeled using generalized estimating equations to account for within-subject correlations and adjusted for age, sex, and race/ethnicity. Results A total of N=124 individuals (65% female) reported suicidal ideation during the study. In unadjusted models, no sleep variable was associated with subsequent suicidal ideation. However, after adjusting for age, sex, and race/ethnicity, insomnia severity was associated with subsequent suicidal ideation when averaged over the preceding 2 weeks (OR 1.09 per point on the ISI, 95% CI [1.03–1.16]) and measured 2 days prior (OR 1.11 per point on the ISI, 95% CI [1.01–1.22]). Stratified analyses showed that this effect was driven by age, with insomnia predicting suicidal ideation in individuals 55–64 and 65 and older. Conclusion Insomnia is a significant, proximal risk factor for suicidal ideation, particularly in older adults. Consequently, treatment of insomnia may represent an effective suicide risk reduction strategy. Support (if any) K24AG055602 R01AG041783

scholarly journals 0182 The Sleep Regularity Questionnaire: Development and Preliminary Psychometric Properties

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A72-A72
Author(s):  
E K Donovan ◽  
J M Dzierzewski
Keyword(s):  
Factor Analysis ◽  
Sleep Quality ◽  
Psychometric Properties ◽  
Factor Model ◽  
Severity Index ◽  
National Institutes Of Health ◽  
Future Research ◽  
Poor Sleep ◽  
Negatively Associated ◽  
Insomnia Severity

Abstract Introduction Sleep is a critically important behavior which influences diverse aspects of health, functioning, and longevity. An increasing literature suggests the importance of sleep regularity, also referred to as sleep inconsistency, sleep variability, or intraindividual variability in sleep. Given there is no brief, subjective measure of sleep regularity, the purpose of this study was to examine the psychometric properties of an in-development, ten-item Sleep Regularity Questionnaire (SRQ). Methods In an online study of sleep and health, participants (n = 3284; Mage (SD)= 42.74(16.72); 47.8% female; 77.1% white) completed the in-development SRQ, as well as other sleep-related measures including the Insomnia Severity Index (ISI) and the Pittsburgh Sleep Quality Index (PSQI). Results An exploratory factor analysis on a random half of the sample revealed a two factor structure, with four items representing “circadian regularity” and two items representing “sleep disturbance regularity.” A confirmatory factor analysis on the other random half of the sample fit the two factor model with good model fit indices (X2 = 50.9, df = 7, p < .001; RMSEA = .06; CFI= .99; NFI = .99; IFI = .99; TLI = .98). The SRQ was negatively associated with poor sleep quality measured via the PSQI (r = -.37, p < .001) and negatively associated with insomnia severity measured via the ISI (r = -.40, p < .001). Conclusion The SRQ appears to be a valid instrument for the assessment of sleep regularity in adults that is related to, but distinct from, other established sleep constructs. Future research will benefit from examining test-retest reliability of the measure as well as assessing the validity of the SRQ as a measure of objective sleep regularity by comparing it to conventional diary, actigraphy, and/or polysomnography methods of sleep assessment. Support This work was supported by the National Institute on Aging of the National Institutes of Health under Award Number K23AG049955 (PI: Dzierzewski). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

scholarly journals Validation of the Insomnia Severity Index on Patients Recovering from High Impact Car Accidents

2021 ◽  
Vol 3 (3) ◽  
pp. 29-33
Author(s):  
Zack Z. Cernovsky ◽  
Larry C. Litman ◽  
Vitalina Nosonova
Keyword(s):  
Convergent Validity ◽  
Motor Vehicle ◽  
Community Sample ◽  
Severity Index ◽  
High Impact ◽  
Clinical Population ◽  
Insomnia Severity Index ◽  
Clinical Assessments ◽  
Insomnia Severity ◽  
Anxiety Questionnaire

Background: The Insomnia Severity Index (ISI) is widely used in clinical assessments of insomnia in patients injured in high impact motor vehicle accidents (MVAs). This study examines the criterion and convergent validity of ISI on this clinical population. Method: De-identified archival data were available on 112 post-MVA patients (37 men, 75 women, mean age 38.8 years, SD=13.1). They completed the ISI as well as the Brief Pain Inventory, the Rivermead Post-concussion Symptoms Questionnaire, the Subjective Neuropsychological Symptoms Scale (SNPSS), Items 10 to 12 of the Whiplash Disability Questionnaire (ratings of depression, anger, and of anxiety), Whetstone Vehicle Anxiety Questionnaire, Driving Anxiety Questionnaire (DAQ), Steiner’s Automobile Anxiety Inventory, and some of them also completed the PTSD Checklist for DSM-5 (PCL-5). The ISI responses were also available from a community sample of 21 controls (10 men, 11 women, mean age of 39.2 years, SD=18.5). Results: The mean ISI total score of post-MVA patients (23.6, SD=13.1) was significantly higher than the one of the controls (6.0, SD=5.4) and significant between groups differences in the same direction were also observed on all 7 individual ISI items: the magnitude of these underlying relationships ranged from Pearson point biserial r of 0.68 to 87. The ISI total score also significantly correlated with ratings of post-MVA pain, depression, generalized anxiety, scores on measures of the post-concussion and whiplash syndrome, PTSD, and on Whetstone’s and DAQ measures of post-MVA driving anxiety. Discussion and Conclusions: The results show an excellent level of criterion and convergent validity of ISI for clinical assessments of insomnia in post-MVA patients.

319 Validation of the Insomnia Severity Index Short-Form for Identifying Insomnia Disorder in Young Adult Cancer Survivors

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A128-A128
Author(s):  
Lydia Chevalier ◽  
Alexis Michaud ◽  
Eric Zhou ◽  
Grace Chang ◽  
Christopher Recklitis
Keyword(s):  
Young Adult ◽  
Cancer Survivors ◽  
Sensitivity And Specificity ◽  
Short Form ◽  
A Priori ◽  
Severity Index ◽  
Young Adult Cancer Survivors ◽  
Adult Cancer Survivors ◽  
Young Adult Cancer ◽  
Insomnia Severity

Abstract Introduction Insomnia is a common and impairing late effect experienced by many young adult cancer survivors (YACS). Although routine evaluation of sleep disorders in cancer survivors is recommended, lack of consensus on appropriate screening measures contributes to under-identification and under-treatment of these disorders in YACS. As screening measures are ideally as brief as possible while maintaining validity, we sought to validate the recently published three-item Insomnia Severity Index Short-Form (ISI-SF) in YACS. Methods 250 YACS completed the ISI and the Structured Clinical Interview for the DSM-5 (SCID-5). The ISI-SF was created by summing three ISI items: distress (item #6), interference (item #7), and satisfaction (item #4). In receiver operating characteristic (ROC) analyses, area under the curve (AUC) was calculated to compare discrimination on the ISI-SF to two criteria: the full-scale ISI using a cutoff of ≥8 recently validated in this sample, and the SCID-5 insomnia module. Consistent with previous research, we specified a priori that a cut-off score on the ISI-SF with sensitivity ≥.85 and specificity ≥.75 would be acceptable. Results The ISI-SF had excellent discrimination when compared to the full-scale ISI (AUC = .97) and a cut-off score of ≥4 met criteria with a sensitivity of 97% and specificity of 86%. The ISI-SF had good discrimination when compared to the SCID-5 (AUC = .88), but none of the cut-off scores met a priori criteria for sensitivity and specificity. A cut-off score of ≥4 came closest with a sensitivity of 94% and specificity of 70%. Conclusion Although the ISI-SF did not meet sensitivity and specificity criteria for a stand-alone screening measure when compared to a diagnostic interview, it demonstrated utility as the first step in a two-step screening procedure. Specifically, the high sensitivity of the ≥4 ISI-F cut-off score is well-suited to accurately screening out YACS who do not need insomnia services; as a second screen, the SCID-5 insomnia module could be administered only to those elevated on the ISI-SF in order to identify false positives cases before making referrals for insomnia specialists. Support (if any) National Cancer Institute (1R21CA223832), Swim Across America

379 Do Depressive Symptoms Mediate the Association Between Insomnia and Physical Activity?

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A150-A151
Author(s):  
Jamie Walker ◽  
Rebecca Campbell ◽  
Ivan Vargas
Keyword(s):  
Physical Activity ◽  
Depressive Symptoms ◽  
Online Survey ◽  
Longitudinal Design ◽  
Energy Levels ◽  
Depression Scale ◽  
Severity Index ◽  
Future Research ◽  
Activity Levels ◽  
Insomnia Symptoms

Abstract Introduction Insomnia and depression are highly comorbid and have been shown to be independently associated with lower levels of physical activity. It is not clear, however, if being less physically active is a risk factor for or consequence of depression and insomnia. The factors that explain the associations between insomnia, depression, and physical activity are likely complex and overlapping. For example, insomnia may predict inactivity by impacting one’s energy levels, leaving them too tired to exercise. Insomnia may also interfere with one’s motivation to exercise due to low mood, as insomnia is associated with the development of depressive symptoms. The purpose of the present study was to explore whether depression mediated the link between insomnia and low levels of physical activity. Methods A national online survey was conducted from April-June 2020. Participants completed surveys to assess demographics, mood, sleep, and physical activity. Depressive symptoms were estimated with the Center for Epidemiologic Studies Depression Scale (CES-D). Insomnia symptoms were estimated with the Insomnia Severity Index (ISI). Physical activity levels were estimated with the International Physical Activity Questionnaire (IPAQ). Analyses were conducted using multiple linear regression, with separate models for depression, insomnia, and the combination of the two, on levels of physical activity. Results 3,952 adults (Mage = 46.9 years) completed the survey. According to the unadjusted models, greater insomnia symptoms were associated with greater depressive symptoms (b = 0.4523, SE = 0.019593, p < .001), and lower levels of physical activity (b = -38.741, SE = 18.236, p = 0.0337). The relationship between insomnia and physical activity was no longer significant, however, when controlling for depression (b = -6.140, SE = 19.274, p = 0.75). According to the mediation analyses, there was an indirect effect of insomnia on physical activity that was explained by differences in depressive symptoms (Sobel Test = -4.895, SE = 6.518, p < .001). Conclusion Our findings support previous research indicating associations between symptoms of insomnia and depression and physical activity. Future research should examine if these same results hold using a longitudinal design. Support (if any) Vargas: K23HL141581

scholarly journals Sleep Disturbances in Individuals Quarantined Due to SARS-CoV-2 Pandemic in Poland: A Mixed Methods Design Study

2021 ◽  
Vol 10 ◽  
pp. 216495612110207
Author(s):  
Sabina Krupa ◽  
Witt Paweł ◽  
Wioletta Mędrzycka-Dąbrowska ◽  
Agnieszka Lintowska ◽  
Dorota Ozga
Keyword(s):  
Mixed Methods ◽  
Sleep Disturbances ◽  
Acute Stress ◽  
Sleep Problems ◽  
Severity Index ◽  
Structured Interview ◽  
Mixed Methods Design ◽  
Design Study ◽  
Insomnia Severity Index ◽  
Insomnia Severity

Objectives The study aimed to assess sleep disturbances in patients subjected to home quarantine due to suspected SARS-CoV-2 infection. The study used a mixed methods design study as a research methodology. Methods A semi-structured interview and the scale for Insomnia Severity Index (ISI) were used to achieve the aim of the study. The survey was conducted from 16 to 20 April 2020 and 1 to 2 September 2020 in Poland, at the during of SARS-CoV-2 epidemic in this country. The data were coded and cross-processed. The (COREQ) checklist was followed. Results Interviews with patients and a thorough analysis of recordings revealed commonly used phrases in the following categories: “anxiety”, “ Am I going crazy?”, “Sleep problems”. 10 out of 11 respondents reported sleep disorders of varying severity according to the Insomnia Severity Index scale. Patients presented a fear related to the return to society and normal functioning after quarantine. Additionally, some study participants voiced concerns related to their mental health; some cases of hallucinations were reported. Conclusions Further global population studies should be conducted to analyse this phenomenon. Acute Stress Disorder should be understood as a threat to life and health of an isolated society in quarantine. Further research in this area should be promoted and the need for global guidelines for the entire population should be developed.

Sleep symptomatology is associated with greater subjective cognitive concerns: Findings from the community-based Healthy Brain Project

SLEEP ◽  
2021 ◽  
Author(s):  
Jessica Nicolazzo ◽  
Katharine Xu ◽  
Alexandra Lavale ◽  
Rachel Buckley ◽  
Nawaf Yassi ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Sleep Quality ◽  
Cognitive Performance ◽  
Sex Education ◽  
Severity Index ◽  
Analysis Of Covariance ◽  
Psychomotor Function ◽  
Community Based ◽  
The Relationship ◽  
Insomnia Severity

Abstract Study objectives To examine if sleep symptomatology was associated with subjective cognitive concerns or objective cognitive performance in a dementia-free community-based sample. Methods A total of 1421 middle-aged participants (mean±standard deviation = 57±7; 77% female) from the Healthy Brain Project completed the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), and Epworth Sleepiness Scale (ESS) to measure sleep quality, insomnia symptom severity, and daytime sleepiness, respectively. Participants were classified as having no sleep symptomatology (normal scores on each sleep measure), moderate sleep symptomatology (abnormal scores on one sleep measure), or high sleep symptomatology (abnormal scores on at least two sleep measures), using established cut-off values. Analysis of covariance was used to compare objective cognitive function (Cogstate Brief Battery) and subjective cognitive concerns (Modified Cognitive Function Instrument) across groups. Results Following adjustments for age, sex, education, mood, and vascular risk factors, persons classified as having high sleep symptomatology, versus none, displayed more subjective cognitive concerns (d=0.24) but no differences in objective cognitive performance (d=0.00-0.18). Subjective cognitive concerns modified the association between sleep symptomatology and psychomotor function. The strength of the relationship between high sleep symptomatology (versus none) and psychomotor function was significantly greater in persons with high as compared with low cognitive concerns (β±SE =-0.37±0.16; p=0.02). Conclusions More severe sleep symptomatology was associated with greater subjective cognitive concerns. Persons reporting high levels of sleep symptomatology may be more likely to display poorer objective cognitive function in the presence of subjective cognitive concerns.

639 An exploratory study of parents-child co-sleeping in Korea

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A250-A250
Author(s):  
Solbi Kang ◽  
Seockhoon Chung ◽  
Sooyeon Suh
Keyword(s):  
Sleep Problems ◽  
Age Groups ◽  
Severity Index ◽  
T Test ◽  
Average Score ◽  
Bed Sharing ◽  
Parents And Children ◽  
Waking Up ◽  
Children’S Sleep ◽  
Insomnia Severity

Abstract Introduction Asian cultures, including Korea, are known to have a higher proportion of parent-child co-sleeping than Western cultures. While recent studies have shown that bed-sharing increases the mother’s depression and causes sleep problems for children, there has never been a study in Asia on the sleep problems of parents and children caused by co-sleeping. Therefore, we aim to investigate the types of sleep problems in children and their mothers’ insomnia severity due to co-sleeping. Methods This study was conducted in 79 mothers (mean age 33.65 ±3.98 years) who reported having insomnia due to their children. All participants had children between 6 to 36 months old. Participants were asked to answer the survey includes demographics, sleep environment, child’s sleep problems, child’s health status items and the mother’s insomnia (measured by the Insomnia Severity Index; ISI). Children’s age was divided into 5 age groups (6 – 11, 12 - 17, 18 - 23, 24 - 29, and 30 to 36 months). Frequency analysis and independent t-test were conducted. Results Of the total respondents, 72.2% (n=57) reported co-sleeping with their children. The most reported sleep problem in children was waking up in the middle of the night 51.9% (n=41), followed by difficulty in sleep initiation 12.7% (n=10), looking for mother or an attachment object 12.7% (n=10), sleep-limiting problems 7.5% (n=6), multiple problems 12.7% (n=10), and none 2.5% (n=2). An independent t-test results for determining whether co-sleeping caused a difference in the severity of maternal insomnia was significant in the 6 to 11 months group only (t=-2.336, p<.05). The co-sleeping mother’s ISI average score (M=18.28) was significantly higher than mother who slept separate from her child (M=14.31). Conclusion Co-sleeping in Asian cultures is prevalent, and may require attention and intervention for mothers who report having insomnia due to their children’s sleep disturbance. Support (if any):

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