scholarly journals 0459 Is It Having a Baby or Me? Differentiating Insomnia Disorder and Sleep Disruption from Pregnancy to 2 Years Postpartum

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A176-A176
Author(s):  
N Quin ◽  
J Lee ◽  
D M Pinnington ◽  
L Shen ◽  
R Manber ◽  
...  
Keyword(s):  
Specific Treatment ◽  
Structured Interview ◽  
Sleep Disruption ◽  
Depression And Anxiety ◽  
Sleep Complaints ◽  
Time Points ◽  
Maternal Sleep ◽  
Insomnia Disorder ◽  
Pregnancy And Postpartum ◽  
Sleep Condition

Abstract Introduction Insomnia Disorder (Insomnia) diagnosis requires sleep complaints to persist despite “sleep-conducive conditions and adequate sleep opportunity”. Women experience significant sleep disruption during pregnancy and postpartum periods due to physiological changes and night-time infant care, but not all women with sleep complaints meet Insomnia criteria. This study examined sleep and mental health correlates of Insomnia Disorder and sleep complaints in the context of a randomised controlled trial for improving maternal sleep. Methods 163 generally healthy first-time mothers (age M±SD=33.4±3.5) with singleton pregnancy repeated the following assessments at 28-30 and 35-36 weeks’ gestation, and 1.5, 3, 6, 12, and 24 months postpartum: the Insomnia module of the Duke Structured Interview for Sleep Disorders, PROMIS Sleep-Related Impairment, Depression, and Anxiety Short Forms. We compared clinical features when DSM-5 Insomnia criteria (less the 3-month criteria) were (1) met (Insomnia), (2) not met only because of the sleep condition/opportunity criteria (Sleep Disruption), and (3) not met due to low symptom/distress (Low Complaint). Results 944 interviews and 1009 questionnaire were collected across 7 time-points. Proportions of women meeting Insomnia criteria were 16.0% and 19.8% during early and late third trimester, and ranged 5.3-11.7% during the 5 postpartum time-points. If the sleep condition/opportunity criteria were not considered, rates of “Insomnia” would have been 2-4 times higher at 21.4-40.4% across all time-points. Mixed effects models, controlling for intervention allocation, showed that compared with Insomnia, Sleep Disruption had comparable depression (p=.68) and anxiety (p=.23), and somewhat lower sleep-related impairment (p=.06). These symptoms were lowest for Low Complaint. Conclusion Both Insomnia and Sleep Disruption were associated with significant daytime impairment, depression, and anxiety. Assessing sleep complaints without considering sleep condition/opportunity can result in over-diagnosis of perinatal Insomnia in these women with primarily sleep disruption; these women may have limited benefits from Insomnia-specific treatment. Interventions for maternal sleep should carefully differentiate between Insomnia and other sleep concerns (e.g., sleep disruption/opportunity, sleepiness/fatigue) and appropriately address each. Support Australasian Sleep Association, Monash University, Royal Women’s Hospital Foundation. National Health and Medical Research Council, Department of Education and Training.

Differentiating perinatal Insomnia Disorder and sleep disruption: A longitudinal study from pregnancy to 2 years postpartum

SLEEP ◽  
2022 ◽  
Author(s):  
Nina Quin ◽  
Jin Joo Lee ◽  
Donna M Pinnington ◽  
Louise Newman ◽  
Rachel Manber ◽  
...  
Keyword(s):  
Mental Health ◽  
Longitudinal Study ◽  
Controlled Trial ◽  
Structured Interview ◽  
Sleep Disruption ◽  
Depression And Anxiety ◽  
P Values ◽  
Sleep Complaints ◽  
Insomnia Disorder ◽  
Randomised Controlled

Abstract Study Objectives Insomnia Disorder diagnoses require persistent sleep complaints despite “adequate sleep opportunity”. Significant perinatal sleep disruption makes this diagnosis challenging. This longitudinal study distinguished between Insomnia Disorder and Perinatal Sleep Disruption and their sleep and mental health correlates. Methods 163 nulliparous females (age M±SD=33.35±3.42) participating in a randomised-controlled trial repeated the Insomnia Disorder module of the Duke Structured Interview for Sleep Disorders and PROMIS measures for sleep and mental health at 30 and 35 weeks’ gestation, and 1.5, 3, 6, 12, and 24 months postpartum (944 interviews, 1009 questionnaires completed). We compared clinical features when DSM-5 Insomnia Disorder criteria were: (1) met (Insomnia Disorder), (2) not met only because of the sleep opportunity criteria (Perinatal Sleep Disruption), and (3.) not met due to other criteria (Low Complaint). Results Proportions of Insomnia Disorder were 16.0% and 19.8% during early and late third trimester, and ranged 5.3-11.7% postpartum. If the sleep opportunity criteria were not considered, rates of Insomnia would be 2-4 times higher (21.4-40.4%) across time-points. Mixed effects models adjusting for covariates showed that compared to Low Complaint, both Insomnia Disorder and Perinatal Sleep Disruption scored significantly higher on insomnia and sleep disturbance scales, sleep effort, and sleep-related impairments (p-values<.01), but depression and anxiety were comparable (p-values>.12). Conclusion Assessing sleep complaints without considering sleep opportunity can result in over-diagnosis of Insomnia Disorder in the perinatal periods. Insomnia Disorder and perinatal sleep disruption were associated with adverse sleep and mood outcomes, and need to be carefully differentiated and appropriately addressed.

Dropout from an internet-delivered CBT Intervention for Adults with Depression and Anxiety: A Qualitative Study (Preprint)

2020 ◽  
Author(s):  
Kate Lawler ◽  
Caroline Earley ◽  
Ladislav Timulak ◽  
Angel Enrique ◽  
Derek Richards
Keyword(s):  
Online Communication ◽  
Structured Interview ◽  
Routine Care ◽  
Drop Out ◽  
Group Differences ◽  
Dropping Out ◽  
Completion Rates ◽  
Depression And Anxiety ◽  
Lower Treatment ◽  
Perceived Change

BACKGROUND Treatment dropout continues to be reported from iCBT interventions and lower completion rates are generally associated with lower treatment effect sizes. However, evidence is emerging to suggest that completion of a pre-defined number of modules is not always necessary for clinical benefit nor considerate of the needs of each individual patient. OBJECTIVE The study aimed to carry out a qualitative analysis of patients’ experiences of an iCBT intervention in a routine care setting in order to achieve a deeper insight into the phenomenon of dropout. METHODS Fifteen purposively sampled participants (8 female) from a larger parent RCT were interviewed via telephone using a semi-structured interview schedule that was developed from the existing literature and research on dropout in iCBT. Data was analysed using the descriptive-interpretive approach. RESULTS The experience of treatment leading to dropout can be understood in terms of ten domains: Relationship to Technology, Motivation to Start, Background Knowledge and Attitudes towards iCBT, Perceived Change in Motivation, Usage of the Programme, Changes due to the Intervention, Engagement with Content, Experience Interacting with the Supporter, Experience of Online Communication and Termination of the Supported Period. CONCLUSIONS Patients who drop out of treatment can be distinguished in terms of their change in motivation: those who felt ready to leave treatment early and those who had negative reasons for dropping out. These two groups of participants have different treatment experiences, revealing potential attributes and non-attributes of dropout. The reported between group differences should be examined further to consider those attributes that are strongly descriptive of the experience and regarded with less importance those that have become loosely affiliated.

Location, Location, Location: Accelerometer Placement Affects Steps-Based Physical Activity Outcomes During Pregnancy and Postpartum

2021 ◽  
pp. 155982762110304
Author(s):  
Mallory R. Marshall ◽  
Alexander H. K. Montoye ◽  
Michelle R. Conway ◽  
Rebecca A. Schlaff ◽  
Karin A. Pfeiffer ◽  
...  
Keyword(s):  
Physical Activity ◽  
Repeated Measures ◽  
Time Points ◽  
Repeated Measures Analysis ◽  
Pregnancy And Postpartum ◽  
Vigorous Intensity ◽  
The Right ◽  
Physical Changes ◽  
Intensity Classification ◽  
Measurement Validity

As pregnancy progresses, physical changes may affect physical activity (PA) measurement validity. n = 11 pregnant women (30.1 ± 3.8 years) wore ActiGraph GT3X+ accelerometers on the right hip, right ankle, and non-dominant wrist for 3–7 days during the second and third trimesters (21 and 32 weeks, respectively) and 12 weeks postpartum. Data were downloaded into 60-second epochs from which stepping cadence was calculated; repeated-measures analysis of variance was used to determine significant differences among placements. At all time points, the wrist accelerometer measured significantly more daily steps (9930–10 452 steps/d) and faster average stepping cadence (14.5–14.6 steps/min) than either the hip (4972–5944 steps/d, 7.1–8.6 steps/min) or ankle (7161–8205 steps/d, 10.3–11.9 steps/min) placement, while moderate- to vigorous-intensity activity at the wrist (1.2–1.7 min/d) was significantly less than either hip (3.0–5.9 min/d) or ankle (6.1–7.3 min/d). Steps, cadence, and counts were significantly lower for the hip than the ankle at all time points. Kappa calculated for agreement in intensity classification between the various pairwise comparisons ranged from .06 to .41, with Kappa for hip–ankle agreement (.34–.41) significantly higher than for wrist–ankle (.09–.11) or wrist–hip (.06–.16). These data indicate that wrist accelerometer placement during pregnancy likely results in over counting of PA parameters and should be used with caution.

scholarly journals A brief sleep focused psychoeducation program for sleep-related outcomes in new mothers: a randomized controlled trial

SLEEP ◽  
2020 ◽  
Vol 43 (11) ◽  
Author(s):  
Liora Kempler ◽  
Louise A Sharpe ◽  
Nathaniel S Marshall ◽  
Delwyn J Bartlett
Keyword(s):  
Sleep Quality ◽  
Daytime Sleepiness ◽  
Linear Mixed Model ◽  
Intervention Group ◽  
Control Group ◽  
Poor Sleep ◽  
Maternal Sleep ◽  
Pregnancy And Postpartum ◽  
Secondary Outcomes ◽  
Insomnia Symptoms

Abstract Study Objectives Poor sleep is commonly problematic during pregnancy and postpartum and is associated with depression. This trial investigated the efficacy of prenatal brief, group sleep psychoeducation in improving postpartum maternal sleep, and depression. Methods A total of 215 healthy expectant first-time mothers were cluster randomized (1:1) to receive either a 2 × 1.5 h psychoeducation intervention and a set of booklets, or a set of booklets only. Participants completed questionnaires during pregnancy (pre-intervention), and 6 weeks and 4 months postpartum. A post hoc subset of questionnaires was collected at 10 months postpartum. The primary hypothesis was the intervention group would have improved postpartum sleep quality, and reduced levels of insomnia symptoms, fatigue, and daytime sleepiness compared to the control group. Secondary outcomes included depression, anxiety, and stress. Results Linear mixed model analyses failed to confirm a group by time interaction on primary or secondary outcomes across all time points. There was no effect of the intervention on outcomes at 6 weeks, or 10 months postpartum. A significant time by group interaction was found at 4 months, favoring the intervention for sleep quality (p = 0.03) and insomnia symptoms (p = 0.03), but not fatigue or daytime sleepiness. Conclusions Prenatal sleep psychoeducation did not produce a sustained effect on maternal sleep throughout the postpartum period. There was little evidence of benefits on depressive symptoms. Clinical Trial Registration ACTRN12611000859987

scholarly journals Effects of Northbound Long-Haul International Air Travel on Sleep Quantity and Subjective Jet Lag and Wellness in Professional Australian Soccer Players

2015 ◽  
Vol 10 (5) ◽  
pp. 648-654 ◽  
Author(s):  
Peter Fowler ◽  
Rob Duffield ◽  
Kieran Howle ◽  
Adam Waterson ◽  
Joanna Vaile
Keyword(s):  
Air Travel ◽  
Soccer Players ◽  
Sleep Disruption ◽  
Jet Lag ◽  
Time Zone ◽  
Sleep Quantity ◽  
Time Points ◽  
Departure Time ◽  
Australian Football ◽  
Home Training

The current study examined the effects of 10-h northbound air travel across 1 time zone on sleep quantity, together with subjective jet lag and wellness ratings, in 16 male professional Australian football (soccer) players. Player wellness was measured throughout the week before (home training week) and the week of (away travel week) travel from Australia to Japan for a preseason tour. Sleep quantity and subjective jet lag were measured 2 d before (Pre 1 and 2), the day of, and for 5 d after travel (Post 1–5). Sleep duration was significantly reduced during the night before travel (Pre 1; 4.9 [4.2−5.6] h) and night of competition (Post 2; 4.2 [3.7−4.7] h) compared with every other night (P < .01, d > 0.90). Moreover, compared with the day before travel, subjective jet lag was significantly greater for the 5 d after travel (P < .05, d > 0.90), and player wellness was significantly lower 1 d postmatch (Post 3) than at all other time points (P < .05, d > 0.90). Results from the current study suggest that sleep disruption, as a result of an early travel departure time (8 PM) and evening match (7:30 PM), and fatigue induced by competition had a greater effect on wellness ratings than long-haul air travel with a minimal time-zone change. Furthermore, subjective jet lag may have been misinterpreted as fatigue from sleep disruption and competition, especially by the less experienced players. Therefore, northbound air travel across 1 time zone from Australia to Asia appears to have negligible effects on player preparedness for subsequent training and competition.

scholarly journals Validation of a French version of the Sleep Condition Indicator: a clinical screening tool for insomnia disorder according to DSM-5 criteria

2017 ◽  
Vol 26 (6) ◽  
pp. 702-708 ◽  
Author(s):  
Sophie Bayard ◽  
Cindy Lebrun ◽  
Khaalid Hassan Maudarbocus ◽  
Vanessa Schellaert ◽  
Alicia Joffre ◽  
...  
Keyword(s):  
Screening Tool ◽  
Clinical Screening ◽  
French Version ◽  
Dsm 5 ◽  
Insomnia Disorder ◽  
Sleep Condition ◽  
Condition Indicator

scholarly journals Relationships of coping styles and psychological distress among patients with insomnia disorder

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yinghui Li ◽  
Xiaoyin Cong ◽  
Suzhen Chen ◽  
Yong Li
Keyword(s):  
Psychological Distress ◽  
Sleep Quality ◽  
Coping Style ◽  
Negative Impact ◽  
Coping Styles ◽  
Targeted Prevention ◽  
Sleep Complaints ◽  
Positive Coping ◽  
Insomnia Disorder ◽  
Negative Coping

Abstract Background Insomnia appears to be one of the most frequent sleep complaints in the general population. It has significant negative impact on daily functioning. However, there has been little research that described the effect of coping style in insomnia disorder. Methods The Simplified Coping Style Questionnaire (SCSQ) was used to evaluate 79 adult patients with insomnia disorder alongside 80 healthy controls. Additionally, sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI), and Symptom Checklist-90-Revised (SCL-90R) was utilized to determine the status of depression, anxiety and other psychological symptoms. Results Positive coping style score was significantly lower, whereas negative coping style score and nine symptomatic dimensions of SCL-90R were significantly higher in insomnia patients than in controls. Positive coping style score was adversely related to PSQI score, obsessive-compulsive, depression, anxiety and phobic anxiety, whereas negative coping style score was positively related to PSQI score, somatization and interpersonal sensitivity. Further multiple stepwise regression analysis showed that PSQI total score was independently and positively correlated with negative coping style score. Conclusions Insomniacs use more negative coping styles and less positive ones. Positive coping is adversely associated with insomnia symptoms and psychological distress, whereas negative coping is positively related to those symptoms. And negative coping has a negative effect on sleep quality. we should attach importance to coping styles of insomniacs in clinical practice, which may help to develop more targeted prevention and intervention strategies.

scholarly journals Depression and anxiety in a community sample with epilepsy in Brazil

2011 ◽  
Vol 69 (2b) ◽  
pp. 342-348 ◽  
Author(s):  
S Stefanello ◽  
L Marín-Léon ◽  
P T Fernandes ◽  
L M Li ◽  
N J Botega
Keyword(s):  
Suicide Attempts ◽  
Community Sample ◽  
Structured Interview ◽  
Cross Sectional Study ◽  
Anxiety And Depression ◽  
Psychiatric Evaluation ◽  
Depression And Anxiety ◽  
Community Based ◽  
Cross Sectional ◽  
The Social

OBJECTIVE: To estimate the frequency of depression/anxiety and to establish the social, epilepsy and psychiatric characteristics in individuals with epilepsy. METHOD: A cross-sectional study was employed to evaluate 153 subjects with epilepsy who were identified in a previous community-based survey. First, a structured interview was conducted, followed by a psychiatric evaluation. Subjects with depression were compared to those without, and subjects with anxiety were compared to those without. RESULTS: The prevalence of anxiety and depression was 39.4 and 24.4%, respectively. Both were associated with low schooling (OR 3.8, 95% CI 1.6 to 9.0 and OR 2.8, 95% CI 1.2 to 6.5 for depression and anxiety, respectively), lifetime suicidal thoughts (OR 4.4, 95% CI 1.9 to 10.3 and OR 3.6, 95% CI 1.7 to 7.7) and lifetime suicide attempts (OR 9.3, 95% CI 2.6 to 32.8 and OR 6.9, 95% CI 1.8 to 26.4). CONCLUSION: The high rates of depression and anxiety reinforced the need for recognition and treatment of mental disorders in epilepsy.

scholarly journals 0554 Insomnia Disorder Predicts Stressful Life Events in Individuals Who Have Recently Experienced Involuntary Job Loss

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A212-A213
Author(s):  
I Skobic ◽  
G Howe ◽  
P L Haynes
Keyword(s):  
Life Events ◽  
Job Loss ◽  
Stressful Life Events ◽  
Secondary Analysis ◽  
Structured Interview ◽  
Stress Generation ◽  
Stressful Life ◽  
Involuntary Job Loss ◽  
Insomnia Disorder

Abstract Introduction The stress generation hypothesis posits that depressed (versus non-depressed) individuals generate more stressful life events, especially events for which they are at least partly responsible (i.e., dependent events). Insomnia disorder interferes with emotion regulation, potentially leading to impaired decision-making and increased stress generation. We hypothesized that insomnia disorder would lead to an increased number of stressful life events in our sample of adults who have recently experienced involuntary job loss. Methods Assessing Daily Activity Patterns through Occupational Transitions is a longitudinal study examining linkages between job-loss, sleep, obesity, and mental health. We used baseline and 3-month follow-up data from 137 participants who completed the Life Events and Difficulties Schedule, a contextual life event measure. Insomnia disorder was coded yes if participants met ICSD-3 criteria for a current chronic or acute insomnia disorder on the Duke Structured Interview for Sleep Disorders. Covariates included age, gender, and race. Linear and logistic regression were employed to assess changes in number of events over time. Secondary analysis examined the relationship between insomnia and dependent stressful life events specifically. Results When controlling for covariates, insomnia disorder at study baseline predicted the number of stressful life events generated between baseline and 3-month follow-up (β =.60, se=.30, t=1.99, p=.05). Conversely, events at baseline did not predict insomnia disorder at follow-up when controlling for baseline insomnia disorder (OR=.98, CI=.82-1.17). Secondary analysis revealed a trend toward increased generation of dependent events among individuals with insomnia disorder (β =.37, se=.23, t = 1.6, p=.11). Conclusion Our analyses provide preliminary evidence for a causal relationship between insomnia disorder and stress generation. Additional research is needed to replicate and examine the mechanisms behind this relationship. This extension of the stress generation hypothesis may have important implications for harm reduction interventions for insomnia disorder. Support #1R01HL117995-01A1.

Psychopathology of alcoholics during withdrawal and early abstinence

2000 ◽  
Vol 15 (8) ◽  
pp. 483-488 ◽  
Author(s):  
T Wetterling ◽  
K Junghanns
Keyword(s):  
Alcohol Withdrawal ◽  
Depressive Disorders ◽  
Specific Treatment ◽  
The Other ◽  
Depression And Anxiety ◽  
Symptom Profile ◽  
Co Morbidity ◽  
Icd 10 ◽  
Severe Psychopathology ◽  
The Impact

Epidemiologic surveys show a high lifetime co-morbidity with psychiatric disorders (e.g., depression and anxiety) in alcoholics. However, alcoholics frequently complained about psychopathologic symptoms, particularly during alcohol withdrawal. There is some evidence that symptomatology decreases spontaneously with prolonged abstinence. Thus, the question arises whether high levels of psychopathology could be accounted for by withdrawal effects. This study was aimed at examining the impact of the alcohol withdrawal severity (assessed by the AWS scale) on psychopathologic symptoms. The psychopathologic profile of 110 alcoholics as measured by the Symptom Checklist-90 revised (SCL-90-R) was compared to that of 253 patients with adjustment, anxiety or depressive disorders (according to ICD-10 criteria). No relationship between the severity of alcohol withdrawal and psychopathology could be found which might hint at two different neurobiological processes underlying these phenomena. The comparison with patients suffering from depression or anxiety disorders revealed that the global symptom severity of alcoholics undergoing withdrawal was similar, but recovery was achieved more rapidly than in the other groups. On the other hand, the self-rated psychopathologic symptom profile of alcoholics was rather similar to that of patients with adjustment disorders. While about one-quarter of the alcoholics reported severe psychopathology on admission, only about 10% showed symptomatology at discharge about three weeks later, predominantly depression or anxiety. These results underline the notion that much of the psychopathology described by alcoholics decreases within 2–3 weeks after withdrawal without specific treatment.

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