371 Insomnia and Metacognitive abilities: a new treatment target?

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A147-A148
Author(s):  
Marco Sforza ◽  
Alessandro Scarpellino ◽  
Andrea Salibba ◽  
Andrea Galbiati ◽  
Marco Zucconi ◽  
...  
Keyword(s):  
Behavioral Therapy ◽  
Sleep Onset ◽  
Severity Index ◽  
Sleep Diary ◽  
Treatment Target ◽  
Metacognitive Abilities ◽  
Metacognitive Activity ◽  
New Treatment ◽  
Insomnia Symptoms ◽  
Group Cbt

Abstract Introduction Metacognition is defined as the ability to reflect on one’s mental state. Literature showed that dysfunctional metacognitive activity (such as worry and rumination) plays an important role in insomnia genesis and maintenance. The aim of this study is (i) to evaluate metacognition differences between insomnia disorders (ID) patients and good sleepers (GS)and (ii) to assess Cognitive-Behavioral Therapy for Insomnia (CBT-I) effectiveness on both insomnia and metacognitive abilities. Methods We compared 27 GS (Insomnia Severity Index, ISI<10) (63.0% female, mean age 33±13.7yrs) and 27 ID patients (51.9% female, mean age 46.4±13.7yrs) evaluated both by ISI and Metacognition Insomnia Questionnaire (MCQ-I). ID patients underwent 7-session of group CBT-I and were evaluated pre- (T0) and post- (T1) treatment. Results GS and ID patients differed in MCQ-I total score (GS=105.6±20.5 vs ID= 138.1±26.2). All ID patients’ scores were above the clinical cutoff of 110. ID patients showed significant improvements both at ISI (T0=14.67±4.67 vs T1=7.07±4.37, p<0.001) and Sleep Diary parameters (T0 vs T1, p<0.05) as sleep latency, wake after sleep onset and sleep efficiency at T1. ID patients also showed an improvement of MCQ-I scores at T1, nevertheless, maintaining MCQ-I the mean score above the clinical cutoff level (MCQ-I_T0=138.1±26.2 vs MCQ-I_T1=123.7±28.6; p<0.05). Indeed, 29.6% of ID patients maintained equal or worse MCQ-I score at T1 compared to T0; 63% of ID patients still had a MCQ-I score above the clinical cutoff at T1. Conclusion CBT-I results effective on insomnia symptoms. Metacognitive dysfunctions appears to be a core feature in ID patients compared to good sleepers. Although the score reduction was significant after CBT-I, metacognitive dysfunction did not show remission after treatment possibly indicating the need of a specific intervention on this aspect. Metacognitive dysfunction in ID needs to be further investigated and may represent a new treatment target, in order to improve CBT-I effectiveness. Support (if any) None

scholarly journals Change in Dysfunctional Sleep-Related Beliefs is Associated with Changes in Sleep and Other Health Outcomes Among Older Veterans With Insomnia: Findings From a Randomized Controlled Trial

2021 ◽  
Author(s):  
Yeonsu Song ◽  
Monica R Kelly ◽  
Constance H Fung ◽  
Joseph M Dzierzewski ◽  
Austin M Grinberg ◽  
...  
Keyword(s):  
Older Adults ◽  
Randomized Controlled Trial ◽  
Behavioral Therapy ◽  
Controlled Trial ◽  
Sleep Onset ◽  
Severity Index ◽  
Sleep Diary ◽  
Daytime Functioning ◽  
Randomized Controlled ◽  
The Impact

Abstract Background Cognitive behavioral therapy for insomnia (CBTI) targets changing dysfunctional sleep-related beliefs. The impact of these changes on daytime functioning in older adults is unknown. Purpose We examined whether changes in sleep-related beliefs from pre- to post-CBTI predicted changes in sleep and other outcomes in older adults. Method Data included 144 older veterans with insomnia from a randomized controlled trial testing CBTI. Sleep-related beliefs were assessed with the Dysfunctional Beliefs and Attitudes about Sleep-16 (DBAS-16, subscales: Consequences, Worry/Helplessness, Sleep Expectations, Medication). Outcomes included sleep diary variables, actigraphy-measured sleep efficiency, Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS), Flinders Fatigue Scale (FFS), Patient Health Questionnaire-9, and health-related quality of life. Analyses compared slope of change in DBAS subscales from baseline to posttreatment between CBTI and control, and assessed the relationship between DBAS change and the slope of change in outcomes from baseline to 6 months. Results Compared to controls, the CBTI group demonstrated stronger associations between improvement in DBAS-Consequences and subsequent improvement in PSQI, ISI, ESS, and FFS. The CBTI group also demonstrated stronger associations between improvement in DBAS-Worry/Helplessness and subsequent improvements in PSQI, ISI, and FFS; improvements in DBAS-Medication and PSQI; and improvements in DBAS-Sleep Expectations and wake after sleep onset (sleep diary) and FFS (all p < .05). Conclusions Significant reduction in dysfunctional sleep-related beliefs following CBTI in older adults predicted improvement in several outcomes of sleep and daytime functioning. This suggests the importance of addressing sleep-related beliefs for sustained improvement with CBTI in older veterans. Trial Registration ClinicalTrials.gov Identifier: NCT00781963.

361 Relative Effectiveness of Cognitive Behavioral Therapy and its Components in Improving Insomnia Symptoms in Older Adults

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A144-A144
Author(s):  
Kathleen O’Hora ◽  
Beatriz Hernandez ◽  
Laura Lazzeroni ◽  
Jamie Zeitzer ◽  
Leah Friedman ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Sleep Onset ◽  
Post Treatment ◽  
Cognitive Behavioral ◽  
Sleep Onset Latency ◽  
Significant Group ◽  
Time Interaction ◽  
Insomnia Symptoms

Abstract Introduction The prevalence of insomnia complaints in older adults is 30–48%, compared to 10–15% in the general population. Cognitive Behavioral Therapy for Insomnia (CBT-I) is a first-line, non-pharmacological sleep treatment for Insomnia. However, the relative impact of Behavioral (BT) and Cognitive (CT) components compared to that of CBT-I in older adults is unknown. Methods 128 older adults with insomnia were randomized to receive CBT-I, BT, or CT. Sleep diaries and the Insomnia Severity Index (ISI) were collected pre- and post-treatment and at a 6-month follow-up. We conducted split-plot linear mixed models with age and sex as covariates to assess within and between subject changes to test effects of group, time, and their interaction on ISI, sleep onset latency (SOL), wake after sleep onset (WASO), total sleep time (TST), time in bed (TIB), sleep efficiency (SE), and percent of treatment responders (ISI decrease>7) and remitters (ISI<8). Effect size (d) was calculated by dividing the difference between means by the root-mean-squared error of the mixed effects model. Results All treatments lead to a significant improvement across outcome measures at post-treatment (p’s<0.001) and 6-months (p’s<0.01), with the exception of TIB, response, and remission. For TIB, there was a significant Group x Time interaction (p<0.001): while all treatments significantly reduced TIB post-treatment relative to baseline, CBT-I (p<0.001,d=-2.26) and BT (p<0.001,d=-1.59) performed significantly better than CT (p=0.003, d=-0.68). In contrast, at 6-months CBT-I (p<0.001,d=-1.16) performed significantly better at reducing TIB than CT (p=0.195,d=-0.24) or BT (p=0.023,d=-0.61) relative to baseline. There was also a non-significant trend for a Group x Time interaction for remission status (p=0.062). Whereas, the percentage of remitters within all groups post-treatment did not differ from chance (p>0.234), at 6 months, the percentage of remitters was significantly higher than chance in CBT-I (73.63%,p=0.026) and BT (78.08%,p=0.012), but not CT (47.85%,p=0.826). There were no other significant time or interaction effects (all p>0.05). Conclusion CBT-I and its components are effective in improving subjective insomnia symptoms in older adults. Evidence suggests CBT-I may be superior to either CT or BT alone in improving TIB in older adults. Support (if any) NIMHR01MH101468; MIRECC at VAPAHCS

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

SLEEP ◽  
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.

scholarly journals The Durability of Cognitive Behavioral Therapy for Insomnia in Patients with Chronic Pain

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Carla R. Jungquist ◽  
Yolande Tra ◽  
Michael T. Smith ◽  
Wilfred R. Pigeon ◽  
Sara Matteson-Rusby ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Short Form ◽  
Severity Index ◽  
Cognitive Behavioral ◽  
Sleep Diary ◽  
Significant Group ◽  
Positive Effects ◽  
End Of Treatment

The purpose of this study was to assess the long-term (six months) effects of cognitive behavioral therapy for insomnia (CBT-I) in patients with chronic pain. The results of the pre-post treatment effects have been reported previously. The therapy was delivered by an advanced practice nurse in a research setting using a parallel-group, randomized, single blind trial of CBT-I with a contact/measurement control condition. Outcomes included sleep diary, the Insomnia Severity Index, the Multidimensional Pain Inventory, the Beck Depression Inventory, the Profile of Mood States-short form, and the Pain Disability Index. Measurement time points were end-of-treatment, three-month and six-month posttherapy. Subjects receiving CBT-I(n=19), as compared to control subjects(n=9), did not exhibit any significant group by visit effects on measures of sleep, pain, mood, or function after end of treatment. However, subjects in the treatment group exhibited statistically(P=0.03)and clinically significant improvement in total sleep time (23 minutes) over the six months following treatment. In this paper, cognitive behavioral therapy directed to improve insomnia was successfully delivered to patients with moderate-to-severe chronic pain and the positive effects of CBT-I continued to improve despite the presence of continued moderate-to-severe pain.

scholarly journals REDUCING DYSFUNCTIONAL BELIEFS ABOUT SLEEP PROVIDES LONG-TERM BENEFIT IN OLDER ADULTS WITH INSOMNIA

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S526-S527
Author(s):  
Yeonsu Song ◽  
Constance Fung ◽  
Joseph Dzierzewski ◽  
Michael Mitchell ◽  
Karen Josephson ◽  
...  
Keyword(s):  
Older Adults ◽  
Behavioral Therapy ◽  
Controlled Trial ◽  
Severity Index ◽  
Post Treatment ◽  
Sleep Diary ◽  
Dysfunctional Beliefs ◽  
Long Term Impact ◽  
Beliefs And Attitudes

Abstract Cognitive behavioral therapy for insomnia (CBTI) is recommended as first-line treatment in older adults. Changing dysfunctional beliefs and attitudes about sleep is an important component of CBTI, but the long-term impact of these changes are unknown, particularly in older adults. Methods involved secondary analyses of data from a large randomized controlled trial comparing CBTI (provided in 5 weekly sessions) to sleep education control, among older veterans with insomnia (N=159, mean age 72.2 years, 97% male, 79% non-Hispanic white). The purpose was to examine whether changes in a validated scale of Dysfunctional Beliefs and Attitudes about Sleep (DBAS) with CBTI treatment (baseline to post-treatment) was associated with later changes in self-reported sleep (post-treatment to 6 months follow-up). Sleep measures included Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS) and 7-day sleep diary measures. Analyses compared the slope of change in DBAS (baseline to post-treatment) between CBTI and control with respect to the slope of change in sleep outcomes (post-treatment to 6-months). Compared to controls, the CBTI group had stronger associations between DBAS improvement (baseline to post-treatment) and subsequent PSQI improvement (post-treatment to 6-months) (difference in slopes=1.3, 95% CI=[.52,2.1], p=0.001). This pattern of significant results was also found for ISI (difference in slopes=1.8, 95% CI=[.58,3.0], p=0.004) and ESS (difference in slopes=1.0, 95% CI=[.25,1.7], p=0.009). Slopes were not different for sleep diary measures. These findings suggest that changing dysfunctional beliefs and attitudes may continue to confer sleep benefits well after completion of CBT-I in older adults.

scholarly journals Efficacy of Face-to-Face Delivered Cognitive Behavioral Therapy in Improving Health Status of Patients With Insomnia: A Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Dawei Xu ◽  
Elizabeth Cardell ◽  
Simon A. Broadley ◽  
Jing Sun
Keyword(s):  
Sleep Quality ◽  
Behavioral Therapy ◽  
Meta Analysis ◽  
Sleep Onset ◽  
Intervention Group ◽  
Severity Index ◽  
Sleep Time ◽  
Control Group ◽  
Sleep Onset Latency ◽  
Face To Face

Background: Face-to-face cognitive behavioral therapy (CBT) is one of the most widely used non-pharmacological treatment approaches for insomnia. The aim of this study is to assess the efficacy of face-to-face delivered CBT on health outcomes and to evaluate the effect of CBT components as subgroup variables to explain the efficacy of face-to-face delivered CBT on health outcomes in adults over 18 years old with insomnia.Methods: Relevant randomized controlled trial studies published in the past 22 years were searched through the electronic databases. The Physiotherapy Evidence Database (PEDro) scale was used to assess the quality of the 31 included studies. The mean difference and standard deviation of outcome variables and subgroup variables were analyzed using random effect model, and the heterogeneity among the articles was assessed with the Q-test and I2. Egger regression analysis was used to assess publication bias.Results: The meta-analysis showed a significant reduction in Insomnia Severity Index [standardized mean difference (SMD) = −2.56, 95% CI −3.81 to −1.30, p < 0.001], Pittsburgh Sleep Quality Index (SMD = −0.96, 95% CI −1.25 to −0.68, p < 0.001), sleep onset latency (SMD = −1.31, 95% CI −2.00 to −0.63, p < 0.001), wakening after sleep onset (SMD = −1.44, 95% CI −2.14 to −0.74, p < 0.001), number of awakenings (SMD = −1.18, 95% CI −2.10 to −0.26, p < 0.05), depression (SMD = −1.14, 95% CI −1.85 to −0.42, p < 0.01), and fatigue (SMD = −2.23, 95% CI −3.87 to −0.58, p < 0.01), and a significant increase in total sleep time (SMD = 0.63, 95% CI 0.28 to 0.98, p < 0.001), sleep efficiency (SMD = 1.61, 95% CI 0.92 to 2.29, p < 0.001), and physical health (SMD = 0.42, 95% CI 0.08 to 0.76, p < 0.05), in the CBT intervention group compared with the control group. There was no significant change in anxiety (SMD = −0.62, 95% CI −1.55 to 0.32, p > 0.05) and mental health (SMD = 1.09, 95% CI −0.59 to 2.77, p > 0.05) in CBT intervention group compared with control group. Group-delivered studies with larger number of intervention sessions and longer duration of single session provided a larger improvement in sleep quality.Conclusion: Face-to-face delivered CBT is effective in increasing total sleep time, sleep efficiency, and physical health, and reducing Insomnia Severity Index scores, Pittsburgh Sleep Quality Index scores, sleep onset latency, wakening after sleep onset, number of awakenings, depression, anxiety, and fatigue in patients with insomnia. Face-to-face delivered CBT is more effective when delivered through a larger number of sessions with longer duration of each session, and when delivered in groups. Face-to-face CBT is recommended to provide treatment to patients with insomnia in clinical settings.Systematic Review Registration:www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020200091, identifier: CRD4202020009.

scholarly journals P129 A substantial percentage of patients with Chronic Insomnia do not appreciably increase Total Sleep Time after Cognitive Behavioural Therapy for Insomnia

2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A63-A63
Author(s):  
H Scott ◽  
J Cheung ◽  
A Muench ◽  
H Ivers ◽  
M Grandner ◽  
...  
Keyword(s):  
Total Sleep Time ◽  
Sleep Onset ◽  
Severity Index ◽  
Randomised Clinical Trial ◽  
Sleep Time ◽  
Early Morning ◽  
Behavioural Therapy ◽  
Sleep Diary ◽  
Wake Time ◽  
Sleep Continuity

Abstract Introduction Total sleep time (TST) does not exceed baseline for the majority of patients after CBT-I. However by follow-up, TST increases by almost 1 hour on average. The current study investigated the extent to which this TST improvement is common and assessed for baseline predictors of increased TST after CBT-I. Methods This study is an archival analysis of data from a randomised clinical trial comparing acute CBT-I to acute CBT-I plus maintenance therapy (N = 80). The percent of patients that exceeded baseline TST by ≥30 minutes was assessed at post treatment and 3, 6, 12, and 24 months following treatment. Linear mixed models were conducted to assess the effect of patient demographics (age, sex, ethnicity, marital status), and baseline Sleep Diary-reported sleep continuity and Insomnia Severity Index (ISI) scores on changes in TST. Results 17% of patients achieved an appreciable increase in TST by treatment end, and this proportion only increased to 58% over time. Sleep Diary-reported sleep latency, wake after sleep onset, early morning awakenings, total wake time, TST, and sleep efficiency at baseline were associated with greater increases in TST after CBT-I (interaction ps < .03). Demographics and ISI scores were not significant predictors (interaction ps > .07). Conclusion A substantial proportion of patients do not appreciably increase TST after CBT-I, but patients with more severe sleep continuity disturbances at baseline exhibited the largest improvements. Whether all patients could increase their TST even further after CBT-I is a topic for further investigation.

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

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.

scholarly journals 1198 Efficacy of Direct Thermoelectric Forehead Cooling for Treating Insomnia Symptoms

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A458-A458
Author(s):  
J Schirm ◽  
B Bellamy ◽  
E Nofzinger
Keyword(s):  
Cooling System ◽  
Sleep Onset ◽  
Form Factors ◽  
Post Treatment ◽  
Sleep Diary ◽  
Thermoelectric Coolers ◽  
Beneficial Effects ◽  
Peltier Cooler ◽  
Insomnia Symptoms ◽  
Insomnia Severity

Abstract Introduction Prior studies have shown beneficial effects of forehead cooling in insomnia patients using a device that circulates cooled fluids through a forehead pad. The current study aimed to determine if a device that cooled via direct thermoelectric contact to the forehead via a Peltier cooler would have similar effects in individuals with insomnia symptoms. Such a technology may allow for form factors that may have advantages for some individuals. Methods An intelligent, portable and battery-operated forehead cooling system using thermoelectric coolers (TECs) with a user selectable temperature range between 14C and 18C was used in the study. Individuals with insomnia symptoms (N=30, 25 female) were recruited and studied at 2 geographic locations. Each participant received pre- and post- treatment insomnia severity as well as daily sleep diary assessments over 1 week of baseline and 4 weeks of treatment. Results Participants’ insomnia symptoms improved over baseline in insomnia severity index (M + SD = 19.7 + 3.8 pre- vs 9.4 + 5.3 post-treatment, t = -9.3, p&lt;0.00001), in sleep latency (M + SD = 43.0 + 40.8 minutes pre- vs 20.7 + 22.7 minutes post-treatment, t = 6.8, p&lt;0.00001), in minutes awake after sleep onset (M + SD =63.0 + 59.2 minutes pre- vs 24.5 +34.5 minutes post-treatment, t = 8.0, p&lt;0.00001) and in sleep quality (0-10 scale with 10 = best, M + SD = 4.1 + 1.9 pre- vs 6.8 + 2.2 post-treatment, t = -13.4, p&lt;0.00001). Conclusion Forehead cooling via direct thermoelectric contact to the forehead via a Peltier cooler had beneficial effects on subjective insomnia symptoms. These promising preliminary data suggest the need for further large scale randomized controlled trials to establish the efficacy of forehead-cooling using direct thermoelectric contact to the forehead via a Peltier cooler on insomnia symptoms. Support Ebb Therapeutics, Pittsburgh, PA 15222

scholarly journals 654 Potential Longitudinal Association Between COVID-19 Infection Outcomes and Insomnia Symptoms

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A256-A256
Author(s):  
Ivan Vargas ◽  
Alexandria Muench ◽  
Michael Grandner ◽  
Michael Perlis
Keyword(s):  
General Population ◽  
Negative Impact ◽  
Sleep Onset ◽  
The United States ◽  
Sleep Diary ◽  
Baseline Survey ◽  
Sleep Continuity ◽  
Clinically Significant ◽  
Insomnia Symptoms

Abstract Introduction The COVID-19 pandemic has had an unequivocal negative impact worldwide, including increases in stress related to social isolation, unemployment, grief, and fear of contracting the virus. This increased stress has likely led to a greater prevalence of sleep continuity disturbance (i.e., insomnia) in the general population. The goal of the present study was to assess the prevalence of sleep continuity disturbance (i.e., insomnia) in the United States during the initial months of the pandemic. In addition, longitudinal assessment is currently ongoing in order to further assess participant experiences with COVID-19. Specifically, these follow-up data will be used to assess whether, among those that contracted COVID-19, insomnia at baseline (Time 1) predicts worse outcomes (e.g., symptoms of greater frequency, duration, or severity) upon follow-up (Time 2). Methods A national survey was conducted from April-June 2020. Participants answered questions regarding social distancing practices, mood, sleep, physical activity, and COVID-19 symptoms. Insomnia symptom prevalence and severity were estimated with a retrospective sleep diary and the Insomnia Severity Index (ISI). A follow-up assessment is currently ongoing and will be completed in March 2021. The follow-up survey consists of similar questions and additional items regarding COVID-19 testing, symptoms [frequency, duration, and severity], and outcomes [outpatient treatment, incidence and duration of hospitalization, and incidence and type of respiratory assistance]. Results 4,133 adults (Mage = 45.8 years; range = 18 - 86 years; 78.7% female) completed the baseline survey. The prevalence of clinically significant sleep continuity disturbance (≥ 30 minutes) was 44.6% for sleep latency problems and 36.2% for wake after sleep onset problems. Nearly 34% of subjects reported average total sleep times of less than 7 hours. Over 17% of subjects (n = 719) reported total ISI scores in the clinical range (ISI total score ≥ 15). Conclusion The present study suggests the prevalence of clinically significant insomnia symptoms during COVID-19 remain high in the general population (17–45% depending on definition of insomnia). Similarly, the prevalence of short sleep is elevated. Whether these incident data are associated with COVID-19 outcomes remains to be determined and will be the subject of follow-up analyses in January/February 2021. Support (if any) Vargas: K23HL141581; Perlis: K24AG055602

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