Association between insomnia patients’ pre-treatment characteristics and their responses to distinctive treatment sequences

SLEEP ◽  
2021 ◽  
Author(s):  
Jack D Edinger ◽  
Simon Beaulieu-Bonneau ◽  
Hans Ivers ◽  
Bernard Guay ◽  
Lynda Bélanger ◽  
...  
Keyword(s):  
Mental Health ◽  
Sleep Duration ◽  
Poor Mental Health ◽  
Optimal Treatment ◽  
Pain Disorder ◽  
Subjective Sleep ◽  
Treatment Characteristics ◽  
Remission Rates ◽  
Pre Treatment ◽  
Treatment Sequences

Abstract Study Objectives It is common to provide insomnia patients a second treatment when the initial treatment fails, but little is known about optimal treatment sequences for different patient types. This study examined whether pre-treatment characteristics/traits predict optimal treatment sequences for insomnia patients. Methods A community sample of 211 adults (132 women; Mage = 45.6 ± 14.9 years) with insomnia were recruited. Patients were first treated with behavioral therapy (BT) or zolpidem (Zol). Non-remitting BT recipients were randomized to a second treatment with either Zol or cognitive therapy; non-remitting Zol recipients underwent BT or Trazodone as a second treatment. Remission rates were assessed at the end of the first and second 6-week treatments. We then compared the remission rates of dichotomous groups formed on the basis of gender, age, pretreatment scores on SF36 and Multidimensional Fatigue Scale, the presence/absence of psychiatric/medical comorbidities or pain disorders, and mean subjective sleep duration and efficiency within and across treatment sequences. Results Lower remission rates were noted for those: with a pain disorder, poor mental health perceptions, high MFI fatigue scores, and lower sleep times and efficiencies. Patients with a pain disorder responded best to the BT-to-Zol sequence, whereas patients with more mental impairment, severe fatigue, short sleep, and low sleep efficiency responded poorly to treatment starting with BT. Conclusions Pain, fatigue, poor mental health status, and subjective sleep duration and efficiency all affect response to different insomnia treatment sequences. Findings may guide clinicians in matching insomnia treatments to their patients. Clinical Trial Registration ClinicalTrials.gov Identifier: NCT01651442, Protocol version 4, April 20, 2011, registered June 26, 2012, https://clinicaltrials.gov/ct2/show/NCT01651442?rslt=With&type=Intr&cond=Insomnia&cntry=US&state=US%3ACO&city=Denver&age=12&draw=2&rank=1.

Characterizing psychiatric hypersomnia on campus: contributions of chronotype, insomnia, and tiredness

2021 ◽  
Author(s):  
Louise Beattie ◽  
Georgios Rigas ◽  
Stephany Biello
Keyword(s):  
Mental Health ◽  
Young Adults ◽  
Sleep Duration ◽  
Preliminary Report ◽  
Severity Index ◽  
Poor Mental Health ◽  
Sleep Health ◽  
Future Studies ◽  
Health And Wellbeing ◽  
Sleep Propensity

Study Objectives: The sleep of students contains several features rendering it worthy of independent investigation. Sleep duration is an important aspect of sleep health and wellbeing, however the assessment of psychiatric hypersomnia has been hampered by the absence of a single unitary scale of this construct. With the recent publication of the Hypersomnia Severity Index, research can now examine this condition in greater detail.Methods: Here we consider how the candidate variables of sleep propensity, fatigue, chronotype and insomnia may be associated with hypersomnia scores in a sample of 140 students. Results suggest that hypersomnia was significantly predicted by these measures, but not age or gender. We then model a pathway from chronotype to hypersomnia, including these factors as potential mediators.Results: Results suggest that hypersomnia was significantly predicted by these measures, but not age or gender. The proposed pathway from chronotype to hypersomnia warrants further study.Conclusions: Future studies should expand upon this preliminary report and consider longitudinally and prospectively how hypersomnia is linked to poor mental health in well-characterized samples of students and other young adults.

scholarly journals Reduced Sleep Duration and Sleep Efficiency Were Independently Associated With Frequent Nightmares in Chinese Frontline Medical Workers During the Coronavirus Disease 2019 Outbreak

2021 ◽  
Vol 14 ◽  
Author(s):  
Yi-Qi Lin ◽  
Ze-Xin Lin ◽  
Yong-Xi Wu ◽  
Lin Wang ◽  
Zhao-Nan Zeng ◽  
...  
Keyword(s):  
Mental Health ◽  
Sleep Duration ◽  
Behavioral Problems ◽  
General Health Questionnaire ◽  
Poor Mental Health ◽  
Sleep Efficiency ◽  
Post Traumatic Stress ◽  
General Mental Health ◽  
Care Workers ◽  
Frequent Nightmare

ObjectivesNightmares were related to emotion and behavioral problems and also emerged as one of the core features of post-traumatic stress disorder (PTSD). Our study aimed to investigate the associations of frequent nightmares with sleep duration and sleep efficiency among frontline medical workers in Wuhan during the coronavirus disease 2019 (COVID-19) outbreak.MethodsA total of 528 health-care workers from the province of Fujian providing medical aid in Wuhan completed the online questionnaires. There were 114 doctors and 414 nurses. The age, sex, marital status, and work situation were recorded. A battery of scales including the Pittsburgh Sleep Quality Index (PSQI) and the 12-item General Health Questionnaire (GHQ-12) were used to evaluate subjects’ sleep and general mental health. Frequent nightmares were defined as the response of at least once a week in the item of “nightmare” of PSQI.ResultsFrequent nightmares were found in 27.3% of subjects. The frequent nightmare group had a higher score of PSQI-sleep duration and PSQI-habitual sleep efficiency (frequent nightmares vs. non-frequent nightmares: PSQI-sleep duration, 1.08 ± 0.97 vs. 0.74 ± 0.85, P < 0.001; PSQI-habitual sleep efficiency, 1.08 ± 1.10 vs. 0.62 ± 0.88, P < 0.001). Reduced sleep duration and reduced sleep efficiency were independently associated with frequent nightmares after adjustment for age, sex, poor mental health, and regular sleeping medication use (reduced sleep duration: OR = 1.96, 95% CI = 1.07–3.58, P = 0.029; reduced sleep efficiency: OR = 2.17, 95% CI = 1.09–4.32, P = 0.027). Subjects with both reduced sleep duration and sleep efficiency were also associated with frequent nightmares (OR = 2.70, 95% CI = 1.57–4.65, P < 0.001).ConclusionThe present study found that sleep duration and sleep efficiency were both independently associated with frequent nightmares among frontline medical workers in Wuhan during the COVID-19 pandemic. We should pay attention to nightmares and even the ensuing PTSD symptoms among subjects with reduced sleep duration or sleep efficiency facing potential traumatic exposure.

scholarly journals 1114 Urbanicity And The Sleep-mental Health Relationship

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A423-A424
Author(s):  
J Moore ◽  
A Seixas ◽  
G Casimir ◽  
J Nunes ◽  
F Matadiaby ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Status ◽  
Urban Environment ◽  
Sleep Duration ◽  
Low Income ◽  
Poor Mental Health ◽  
Mental Health Status ◽  
Rural Environment ◽  
The Relationship ◽  
Inadequate Sleep

Abstract Introduction Inadequate sleep has been found to be associated with poor mental health. This is especially true in low-income and minority populations, who are concentrated in cities. It is not understood to what degree living in a city vs. a rural environment affects sleep and resulting mental health outcomes. This study seeks to understand how living in an urban environment affects the relationship between inadequate sleep and mental health. Methods The study used data from the 2018 US Behavioral Risk Factor Surveillance System (BRFSS,) a nationwide health dataset collected by telephone. Respondents were classified as living in either an urban or rural environment based on their zip code. Respondents reported hours of sleep per night and mental health status. This study classified mental health status based on whether the respondent reported one or more incidences of poor mental health in the previous 30 days. Results After filtration, 348,540 respondents were split into urban and rural groups. Binary logistic regression was run in each group to compare how much living in an urban environment contributed to the relationship between sleep duration and mental health. Sleep in the analysis was found to significantly contribute to both models; urban X2(15, N=295,796) = 11,485.70, p <0.001 rural X2(15, N=52,744) = 2,465.64, p <0.001. The estimated odds ratio resulted in a decrease of 13.9% [Exp(B) = 0.861] in reported poor mental health for every unit increase of sleep in the urban population, and decrease of 14.9% [Exp(B) = 0.851] in the rural population. Conclusion In urban and rural dwellers, sleep duration predicted poor mental health. Contrary to expectations, sleep was more strongly tied to mental health in rural than urban populations. This was true even after controlling for sex, income, and education level. Further research should seek to understand how environment affects sleep and mental health. Support This study was supported by funding from the NIH: R01MD007716, R01HL142066, R01AG056531, K01HL135452, and K07AG052685.

scholarly journals Sleep Debt Is Not Associated with Mental Health Among School-Age Adolescents: The Gravity of Short Sleep

2020 ◽  
Vol 30 (3) ◽  
Author(s):  
Seongmin Ro ◽  
Jungmin Lee ◽  
In Cheol Hwang
Keyword(s):  
Mental Health ◽  
Sleep Duration ◽  
Multivariate Logistic Regression Analysis ◽  
Depressive Mood ◽  
Cross Sectional Study ◽  
Poor Mental Health ◽  
Independent Effect ◽  
School Age ◽  
Cross Sectional ◽  
Sleep Debt

Background: Previous research on sleep debt has neglected considering sleep duration on weekdays as a contributing factor. Objectives: This cross-sectional study investigated the relationship between sleep debt and mental health in school-age adolescents, taking weekday sleep deficits under consideration. Methods: We identified 1,392 students who had provided data on sleep duration from the 2016 - 2017 for Korea National Health and Nutrition Examination Survey (KNHANES). A stepwise multivariate logistic regression analysis was used to examine the independent effect of sleep debt on perceived stress or depressive mood. Results: Individuals with poor mental health sleep less on weekdays, resulting in more sleep debt. Final regression models that were adjusted for potential covariates revealed that poor mental health was associated with shortened sleep on weekdays but was not associated with overall sleep debt. Conclusions: Our result suggests that efforts should be made to lengthen sleep on weekdays, not on weekends, to lower stress or depressive mood among adolescents.

A Longitudinal Study of Mental Health in Emerging Adults

2014 ◽  
Vol 73 (3) ◽  
pp. 135-141 ◽  
Author(s):  
Monica S. Bachmann ◽  
Hansjörg Znoj ◽  
Katja Haemmerli
Keyword(s):  
Mental Health ◽  
Longitudinal Study ◽  
Emerging Adults ◽  
Poor Mental Health ◽  
Need Satisfaction ◽  
Computer Assisted ◽  
Consistency Model ◽  
Negative Effect ◽  
The Cross ◽  
Health Model

Emerging adulthood is a time of instability. This longitudinal study investigated the relationship between mental health and need satisfaction among emerging adults over a period of five years and focused on gender-specific differences. Two possible causal models were examined: (1) the mental health model, which predicts that incongruence is due to the presence of impaired mental health at an earlier point in time; (2) the consistency model, which predicts that impaired mental health is due to a higher level of incongruence reported at an earlier point in time. Emerging adults (N = 1,017) aged 18–24 completed computer-assisted telephone interviews in 2003 (T1), 2005 (T2), and 2008 (T3). The results indicate that better mental health at T1 predicts a lower level of incongruence two years later (T2), when prior level of incongruence is controlled for. The same cross-lagged effect is shown for T3. However, the cross-lagged paths from incongruence to mental health are marginally associated when prior mental health is controlled for. No gender differences were found in the cross-lagged model. The results support the mental health model and show that incongruence does not have a long-lasting negative effect on mental health. The results highlight the importance of identifying emerging adults with poor mental health early to provide support regarding need satisfaction.

Sign in / Sign up

Export Citation Format

Share Document