scholarly journals 0514 Efficacy of a Forehead-Cooling Device for Treating Insomnia in Veterans

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A197-A197
Author(s):  
E Nofzinger
Keyword(s):  
Prospective Study ◽  
Large Scale ◽  
Prospective Trial ◽  
Sleep Onset ◽  
Severity Index ◽  
Post Treatment ◽  
Cooling Device ◽  
Insomnia Severity Index ◽  
Before And After ◽  
Insomnia Severity

Abstract Introduction In 2 independent studies, we explored whether a forehead-cooling device was effective in improving insomnia in veterans. Methods Both studies were uncontrolled and exploratory in nature. The first study involved 20 veterans who expressed interest in using the forehead-cooling device and received 4 weeks treatment. The second study involved 19 veterans who were recruited via media to participate in a 4-week study and were compensated for their participation. All participants completed questionnaires before and after treatment. Results In the retrospective analysis, veterans had improvements over baseline in insomnia severity index (M ± SD =17.6 ± 4.7 pre- vs 6.9 ± 3.5 post-treatment, t(19) = -9.4, p<0.00001), in sleep latency (M ± SD = 61.7 ± 49.1 minutes pre- vs 25.0 ± 20.8 minutes post-treatment, t(19) = -4.6, p<0.001) and in minutes awake after sleep onset (M ± SD =78.7 ± 57.8 minutes pre- vs 29.9 ± 18.3 minutes post-treatment, t(19) = -4.0, p<0.001). In the prospective study, veterans had improvements in insomnia severity index over baseline (M ± SD = 20.7 +3.8 pre- vs 9.5 ± 7.5 post-treatment, t(18) = 5.8, p<0.00001), depression severity on the PHQ-9 (M ± SD = 21.5 ±6.1 pre- vs 14.2 ± 5.1 post-treatment, t(18) =4.1, p<0.001) and anxiety severity on the GAD 7 (M ± SD = 9.8 ±7.1 pre- vs. 6.2 ± 5.4 post-treatment, t(18) = -3.1, p<0.01). Conclusion Use of a forehead-cooling device improved insomnia in veterans. These findings were replicated in an independent prospective trial. Reductions in depressive and anxiety symptoms from baseline were also noted in the prospective study. These promising preliminary data suggest the need for further large scale randomized controlled trials to establish the efficacy of forehead-cooling on insomnia in veterans. Support Ebb Pharmaceuticals, Pittsburgh, PA 15222

366 Predictors of Dropout in University Students Participating in an 8-week E-mail Based Cognitive Behavioral Therapy for Insomnia

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A145-A146
Author(s):  
Hyojin Nam ◽  
Jinyoung Chang ◽  
Rachel Manber ◽  
Mickey Trockel ◽  
Isa Okajima ◽  
...  
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Psychological Intervention ◽  
Behavioral Therapy ◽  
Severity Index ◽  
Cognitive Behavioral ◽  
Depression Anxiety Stress Scale ◽  
Insomnia Severity Index ◽  
Before And After ◽  
E Mail ◽  
Insomnia Severity

Abstract Introduction As dropout from treatment potentially diminishes its therapeutic effect and poses clinical concern, it is important to find out which characteristics of participants are suitable for online-based treatment. Therefore, we aimed to identify factors that predicted a dropout in the e-mail based cognitive behavioral therapy (REFRESH) developed by Stanford University for the purpose of psychological intervention for insomnia. Methods Participants who participated in the REFRESH program consisted of 158 university and graduate students aged 18 to 30 in Hong Kong and Korea who scored higher than 10 on the Insomnia Severity Index (ISI), and the intervention was delivered in 8 weekly sessions sent via weekly e-mails. Among them, 110 were women (70%) and the average age was 22 (±2.71) years old. All participants were asked to answer the following self-reporting questionnaires before and after the intervention: Insomnia Severity Index; ISI, Depression Anxiety Stress Scale 21; DASS-21, Sleep Hygiene Practice Scale; SHPS, Dysfunctional Beliefs and Attitude about Sleep 16; DBAS-16. Descriptive statistics and ROC decision tree analysis were conducted to address our aim. Results Of the 158 participants, 68 completed the program, and 90 participants (57%) dropped out. The best predictor of dropout was DASS score with an optimal cup-point of <34. Of the 107 participants who reported DASS <30, 70(65.4%) dropped out. In contrast, of the 50 participants who reported DASS ≥34, 12(38%) dropped out. The second-level predictor was expectations for sleep score with a cut-point of <18. Among participants with DASS <34 and expectations for sleep score <18, 57(73.1%) dropped out. Of the 29 participants who reported DASS <34 and expectations for sleep score ≥18, 13(44.8%) dropped out. Conclusion Mild levels of depression, anxiety and stress and expectations for sleep appear to be predictive of dropout in an e-mail based intervention. People with mild symptoms may experience less distress and impairment, which may result in lower motivation to receive treatment. This may lead to inability to complete treatment and higher rates of dropout. Support (if any):

scholarly journals 0537 Cognitive Functioning Before and After Insomnia Treatment in Women Veterans

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A205-A206
Author(s):  
J M Dzierzewski ◽  
R Zhu ◽  
E K Donovan ◽  
E Perez ◽  
Y Song ◽  
...  
Keyword(s):  
Cognitive Functioning ◽  
Behavioral Therapy ◽  
Women Veterans ◽  
Severity Index ◽  
Post Treatment ◽  
Acceptance And Commitment ◽  
Before And After ◽  
Insomnia Treatment ◽  
Insomnia Severity

Abstract Introduction Women are at higher risk for cognitive impairment and dementia compared to men. Identifying potentially treatable risk factors such as insomnia is an important clinical goal. In a trial comparing two behavioral treatments for insomnia in women veterans, we hypothesized that 1) worse baseline insomnia severity would be associated with poorer cognitive function, and 2) improvement in insomnia severity with treatment would be associated with improvement in cognitive functioning. Methods 347 women veterans with insomnia disorder [mean age 48.3 (12.9) years] completed baseline testing. Of these, 149 women were randomized to receive cognitive behavioral therapy for insomnia (CBT-I) or acceptance and commitment (ACT) based insomnia treatment (both treatments included sleep restriction, stimulus control, and sleep hygiene). Insomnia Severity Index (ISI) was assessed at baseline, post-treatment, and 3-month follow-up. Cognitive functioning was measured with Symbol Digit Coding (SDC) and Trail Making Test A and B (TMTA and TMTB). Pearson correlations were used to examine associations between insomnia severity and cognitive functioning at baseline and changes in both insomnia severity and cognitive functioning from before to after treatment. Results At baseline (N=347), mean ISI was 14.1 (5.3). Worse baseline ISI was associated with worse baseline cognitive functioning on TMTA (r=-.15, p<.01) and SDC (r=-.12, p<.05). In the randomized sample (N=149), ISI scores improved at post-treatment (mean ISI change= -9.0; p<.001) and 3-month follow-up (mean change= -8.0; p<.001) relative to baseline. Improvement in ISI from baseline to post-treatment was significantly associated with improvement in SDC from baseline to post-treatment (r=-.18, p<.05), but not improvement in TMTA and TMTB. Change in ISI was not significantly related to change in cognitive tasks from baseline to 3-month follow-up. Conclusion More severe insomnia is associated with worse cognitive functioning in women veterans. The magnitude of improvement in insomnia symptoms may be associated with improvement in cognition. Support NIH/NIA K23AG049955 (PI: Dzierzewski); VA/HSR&D IIR-HX002300 (PI: Martin), NIH/NHLBI K24HL143055 (PI: Martin).

scholarly journals Swedish Translation and Validation of the Pediatric Insomnia Severity Index

2019 ◽  
Author(s):  
Charlotte Angelhoff ◽  
Peter Johansson ◽  
Erland Svensson ◽  
Anna Lena Sundell
Keyword(s):  
Quality Of Life ◽  
Structural Equation ◽  
Sleep Onset ◽  
Well Being ◽  
Severity Index ◽  
Swedish Version ◽  
Insomnia Severity Index ◽  
Pediatric Insomnia ◽  
Insomnia Severity

Abstract Background: To increase health and well-being in young children, it is important to acknowledge and promote the child’s sleep behaviour. However, there is a lack of brief, validated sleep screening instruments for children. The aim of this study was to present a Swedish version of the Pediatric Insomnia Severity Index (PISI), analyse the structure, test the validity and reliability of the instrument. Methods: The English version of the PISI was translated into Swedish, translated back into English, and agreed upon before use. Parents of healthy 3- to 10-year-old children filled out the Swedish version of the PISI and the generic health-related quality of life instrument KIDSCREEN-27 two times. Exploratory and confirmatory factor analyses for baseline and test-retest, structural equation modelling, and correlations between the PISI and KIDSCREEN-27 were performed Results: In total, 160 parents filled out baseline questionnaires (test), whereof 100 parents (63%) filled out the follow-up questionnaires (retest). Confirmative factor analysis of the PISI found two correlated factors: sleep onset problems (SOP) and sleep maintenance problems (SMP). The PISI had substantial construct and test-retest reliability. The PISI factors influenced all KIDSCREEN-27 dimensions. Conclusions: The Swedish version of the PISI is applicable for screening sleep problems and is a useful aid in dialogues with families about sleep. It is also relevant in research and for evaluation of treatment. Keywords: Child; Child, Preschool; Health Promotion; Sleep; Translations; Pediatrics; Validation Studies; Quality of Life

scholarly journals The Relationship between Fatigue and Actigraphy-Derived Sleep and Rest–Activity Patterns in Cancer Survivors

2021 ◽  
Vol 28 (2) ◽  
pp. 1170-1182
Author(s):  
Tristan Martin ◽  
Rosie Twomey ◽  
Mary E. Medysky ◽  
John Temesi ◽  
S. Nicole Culos-Reed ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Sleep Onset ◽  
Severity Index ◽  
Objective Measures ◽  
Sleep Onset Latency ◽  
Insomnia Severity Index ◽  
Cancer Related Fatigue ◽  
Activity Cycles ◽  
Insomnia Severity ◽  
Rest Activity

Cancer-related fatigue can continue long after curative cancer treatment. The aim of this study was to investigate sleep and rest–activity cycles in fatigued and non-fatigued cancer survivors. We hypothesized that sleep and rest–activity cycles would be more disturbed in people experiencing clinically-relevant fatigue, and that objective measures of sleep would be associated with the severity of fatigue in cancer survivors. Cancer survivors (n = 87) completed a 14-day wrist actigraphy measurement to estimate their sleep and rest–activity cycles. Fatigue was measured using the Functional Assessment of Chronic Illness Therapy Fatigue Scale (FACIT-F). Participants were dichotomised into two groups using a previously validated score (fatigued n = 51 and non-fatigued n = 36). The participant’s perception of sleep was measured using the Insomnia Severity Index (ISI). FACIT-F score was correlated with wake after sleep onset (r = −0.28; p = 0.010), sleep efficiency (r = 0.26; p = 0.016), sleep onset latency (r = −0.31; p = 0.044) and Insomnia Severity Index (ISI) score (r = −0.56; p < 0.001). The relative amplitude of the rest–activity cycles was lower in the fatigued vs. the non-fatigued group (p = 0.017; d = 0.58). After treatment for cancer, the severity of cancer-related fatigue is correlated with specific objective measures of sleep, and there is evidence of rest–activity cycle disruption in people experiencing clinically-relevant fatigue.

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.

scholarly journals The effect of sleep-wake intraindividial variability in digital cognitive behaviour therapy for insomnia: A mediation analysis of a large-scale RCT

SLEEP ◽  
2021 ◽  
Author(s):  
Cecilie L Vestergaard ◽  
Øystein Vedaa ◽  
Melanie R Simpson ◽  
Patrick Faaland ◽  
Daniel Vethe ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Large Scale ◽  
Controlled Trial ◽  
Sleep Onset ◽  
Depression Scale ◽  
Mediating Effect ◽  
Sleep Onset Latency ◽  
Composite Measures ◽  
Cognitive Behaviour ◽  
Insomnia Severity

Abstract Study Objectives Digital Cognitive Behavioural Therapy for Insomnia (dCBT-I) is an effective treatment for insomnia. However, less is known about mediators of its benefits. The aim of the present study was to test if intraindividual variability in sleep (IIV) was reduced with dCBT-I, and whether any identified reduction was a mediator of dCBT-I on insomnia severity and psychological distress. Methods In a two-arm randomized controlled trial (RCT), 1720 adults with insomnia (dCBT-I = 867; patient education about sleep = 853) completed the Insomnia Severity Index (ISI), the Hospital Anxiety and Depression Scale (HADS) and sleep diaries, at baseline and 9-week follow-up. Changes in IIV were analysed using linear mixed modelling followed by mediation analyses of ISI, HADS, and IIV in singular sleep metrics and composite measures (Behavioural Indices (BI-Z) and Sleep-disturbance Indices (SI-Z)). Results dCBT-I was associated with reduced IIV across all singular sleep metrics, with the largest between-group effect sizes observed for sleep onset latency (SOL). Reduced IIV for SOL and wake after sleep onset had the overall greatest singular mediating effect. For composite measures, SI-Z mediated change in ISI (b = -0.74; 95% Confidence Interval (CI) -1.04 to -0.52; 13.3%) and HADS (b = -0.40; 95% CI -0.73 to -0.18; 29.2%), whilst BI-Z mediated minor changes. Conclusion Reductions in IIV in key sleep metrics mediate significant changes in insomnia severity and especially psychological distress when using dCBT-I. These findings offer important evidence regarding the therapeutic action of dCBT-I and may guide the future development of this intervention.

The Relationship Between Smartphone Use, Insomnia, Stress, and Anxiety Among University Students: A Cross-Sectional Study

2020 ◽  
pp. 105477382098316
Author(s):  
Nisreen Al Battashi ◽  
Omar Al Omari ◽  
Murad Sawalha ◽  
Safiya Al Maktoumi ◽  
Ahmed Alsuleitini ◽  
...  
Keyword(s):  
University Students ◽  
Severity Index ◽  
Depression Anxiety Stress Scale ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Insomnia Severity Index ◽  
Stress Scale ◽  
Smartphone Use ◽  
The Relationship ◽  
Insomnia Severity

The rapid increase in the number of smartphone users has raised concern about the negative psychosocial and physical effects of this use. A descriptive cross-sectional design was conducted to investigate the relationship between smartphone use, anxiety and insomnia among university students. A convenience sample of 404 students from one public university completed questionnaires with items from the Smartphone Addiction Scale, the Depression Anxiety Stress Scale and the Insomnia Severity Index, with some demographic data. High smartphone addition scale score was significantly associated with higher anxiety and stress scores of the Depression Anxiety Stress scale, and higher insomnia severity index score. The findings support the importance of an intervention program to promote appropriate use of smartphones and to improve sleep and psychological symptoms such as stress and anxiety among university students.

scholarly journals Mapping of the Insomnia Severity Index and other sleep measures to EuroQol EQ-5D health state utilities

2011 ◽  
Vol 9 (1) ◽  
pp. 119 ◽  
Author(s):  
Ning Yan Gu ◽  
Marc F Botteman ◽  
Xiang Ji ◽  
Christopher F Bell ◽  
John A Carter ◽  
...  
Keyword(s):  
Severity Index ◽  
Health State ◽  
Insomnia Severity Index ◽  
Health State Utilities ◽  
Insomnia Severity

Changes in sleep predict changes in depressive symptoms in depressed subjects receiving vortioxetine: An open-label clinical trial

2019 ◽  
Vol 33 (11) ◽  
pp. 1388-1394 ◽  
Author(s):  
Bing Cao ◽  
Caroline Park ◽  
Joshua D Rosenblat ◽  
Yan Chen ◽  
Michelle Iacobucci ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Sleep Quality ◽  
Epworth Sleepiness Scale ◽  
Quality Index ◽  
Pittsburgh Sleep Quality Index ◽  
Severity Index ◽  
Major Depressive ◽  
Insomnia Severity Index ◽  
Insomnia Severity

Background Sleep disturbances are frequently reported in patients with major depressive disorder. We aimed to investigate the effects of vortioxetine on sleep quality and association between changes in sleep and treatment response. Methods: This study is a post-hoc analysis of a clinical trial that sought to evaluate the sensitivity to cognitive change of THINC-integrated tool in patients with major depressive disorder. In total, 92 patients (aged 18 to 65) meeting Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria for moderate or severe major depressive disorder and 54 healthy controls were included. All patients received open-label vortioxetine (10–20 mg/day, flexibly dosed) for 8 weeks. Herein, the primary outcomes of interest were changes in sleep, as measured by the Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale and Insomnia Severity Index, between weeks 0, 2, and 8. The association between changes in sleep and depressive symptom severity was secondarily assessed. Results: We observed that sleep, as indicated by scores of Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale and Insomnia Severity Index, was significantly poorer in patients with major depressive disorder compared to healthy controls at weeks 0, 2, and 8 ( p < 0.05). Among patients with major depressive disorder, we observed significant improvements on the Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale and Insomnia Severity Index between weeks 0 and 8 ( p < 0.05). We observed a significant association between improvements on the Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, and Insomnia Severity Index and improvement of depressive symptoms. Conclusion: Improvement of depressive symptoms in major depressive disorder patients treated with vortioxetine was associated with significant improvements in sleep. Furthermore, improvements in sleep were predictive of antidepressant response and were linearly correlated with improvement in overall depressive symptom severity.

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