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 Study of correlation between perceived sleep disturbances in depressed patients with objective changes in sleep architecture using polysomnography before and after antidepressant therapy

2020 ◽  
Vol 8 (7) ◽  
pp. 2551
Author(s):  
Ganesh Ingole ◽  
Harpreet S. Dhillon ◽  
Bhupendra Yadav
Keyword(s):  
Sleep Disturbances ◽  
Total Sleep Time ◽  
Antidepressant Treatment ◽  
Sleep Onset ◽  
Sleep Time ◽  
Sleep Efficiency ◽  
Sleep Architecture ◽  
Wake Time ◽  
Depressed Patients ◽  
Before And After

Background: A prospective cohort study to correlate perceived sleep disturbances in depressed patients with objective changes in sleep architecture using polysomnography (PSG) before and after antidepressant therapy.Methods: Patients were recruited into the study after applying strict inclusion and exclusion criterion to rule out other comorbidities which could influence sleep. A diagnosis of Depressive episode was made based on ICD-10 DCR. Psychometry, in the form of Beck Depressive inventory (BDI) and HAMD (Hamilton depression rating scale) insomnia subscale was applied on Day 1 of admission. Patients were subjected to sleep study on Day 03 of admission with Polysomnography. Patients were started on antidepressant treatment post Polysomnography. An adequate trial of antidepressants for 08 weeks was administered and BDI score ≤09 was taken as remission. Polysomnography was repeated post remission. Statistical analysis was performed using Kruskal Wallis test and Pearson correlation coefficient.Results: The results showed positive (improvement) polysomnographic findings in terms of total sleep time, sleep efficiency, wake after sleep onset, percentage wake time and these findings were statistically significant. HAM-D Insomnia subscale was found to correlate with total sleep time, sleep efficiency, wake after sleep onset, total wake time and N2 Stage percentage.Conclusions: Antidepressant treatment effectively improves sleep architecture in Depressive disorder and HAM-D Insomnia subscale correlates with objective findings of total sleep time, sleep efficiency, wake after sleep onset, total wake time and duration of N2 stage of NREM.

A Comparative Study of Sleep and Mood Between Young Elite Athletes and Age-Matched Controls

2017 ◽  
Vol 14 (6) ◽  
pp. 465-473 ◽  
Author(s):  
Anette Harris ◽  
Hilde Gundersen ◽  
Pia Mørk Andreassen ◽  
Eirunn Thun ◽  
Bjørn Bjorvatn ◽  
...  
Keyword(s):  
Physical Activity ◽  
Total Sleep Time ◽  
Elite Athletes ◽  
Sleep Onset ◽  
Sleep Time ◽  
Sleep Diary ◽  
Sleep Onset Latency ◽  
Onset Latency ◽  
Social Jetlag ◽  
Weekly Training

Background:Sleep and mood have seldom been compared between elite athletes and nonelite athletes, although potential differences suggest that physical activity may affect these parameters. This study aims to explore whether adolescent elite athletes differ from controls in terms of sleep, positive affect (PA) and negative affect (NA).Methods:Forty-eight elite athletes and 26 controls participating in organized and nonorganized sport completed a questionnaire, and a 7-day sleep diary.Results:On school days, the athletes and the controls who participated in organized and nonorganized sport differed in bedtime (22:46, 23:14, 23:42, P < .01), sleep onset (23:03, 23:27, 00:12, P < .01), and total sleep time (7:52, 8:00, 6:50, P < 01). During weekend, the athletes, the controls who participated in organized and nonorganized sport differed in bedtime (23:30, 00:04, 00:49, P < .01), sleep onset (23.42, 00:18, 01:13, P < .01), rise time (9:15, 9:47, 10:55, P < .01), sleep efficiency (95.0%, 94.2%, 90.0%, P < 05), and sleep onset latency (11.8, 18.0, 28.0 minutes, P < .01). Furthermore, the athletes reported less social jetlag (0:53) and higher score for PA (34.3) compared with the controls who participated in nonorganized sport (jetlag: 1:25, P < .05, PA: 29.8, P < .05).Conclusions:An almost dose-response association was found between weekly training hours, sleep, social jetlag and mood in adolescents.

scholarly journals 0363 Racial/Ethnic Differences in Actigraphy, Questionnaire, and Polysomnography-Measured Indicators of Sleep Health and Sleep Quality: The Multi-Ethnic Study of Atherosclerosis

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A138-A139
Author(s):  
J Chung ◽  
M O Goodman ◽  
T Huang ◽  
M Wallace ◽  
S Bertisch ◽  
...  
Keyword(s):  
Total Sleep Time ◽  
Sleep Onset ◽  
Well Being ◽  
Sleep Time ◽  
Lower Probability ◽  
Sleep Onset Latency ◽  
Sleep Health ◽  
Ethnic Study ◽  
Sleep Continuity ◽  
Racial Ethnic

Abstract Introduction Paradigm shifts in sleep research suggest the importance of considering multi-dimensional sleep health, compared to single metrics, to promote physical and mental well-being and to understand racial/ethnic disparities in sleep. Methods We used data from the Multi-Ethnic Study of Atherosclerosis (MESA; n = 1,740) to create a Sleep Health Score (SHS), including questionnaire (quality, sleepiness); 7-day actigraphy (total sleep time, sleep continuity [sleep maintenance efficiency], timing consistency [midpoint variability], fragmentation, wake after sleep onset, sleep onset latency); and in-home polysomnography (%N3 sleep, %REM sleep, AHI). Sleep parameters were dichotomized based on prior literature or by healthiest quartile(s), with positive values denoting healthier sleep (e.g. Epworth scores &lt; 10). All 11 dichotomized parameters were summed to calculate the SHS (mean=4.9, sd=1.58). We used modified Poisson and linear regression for individual sleep outcomes and the SHS, respectively, adjusting for age and sex. Results The sample was older (mean age=68.28, sd=9.08) and 54% female. SHSs were associated with Black race (β=-0.60 [-0.78, -0.42]) and Hispanic ethnicity (β=-0.40 [-0.59, -0.21]), but not Chinese ethnicity (β=-0.16 [-0.41, 0.08]). Compared to Whites (n=644), Blacks (n=485) showed lower adjusted probability of obtaining favorable levels of: sleep continuity, fragmentation, timing consistency, alertness/sleepiness, and sleep depth (%N3 sleep). Chinese respondents (n=202) had lower probability of obtaining favorable levels of: sleep continuity and timing consistency, but higher probability of quality. Hispanics (n=409) had lower probability of obtaining healthy levels of: sleep continuity, timing consistency, and fragmentation. Neither healthy total sleep time (middle quartiles) nor AHI (&lt;30) differed by race/ethnicity. Conclusion Among MESA-Sleep participants, summary SHSs were lowest in Blacks, followed by Hispanics. Multiple dimensions of sleep - particularly related to continuity and timing consistency - were less favorable across race/ethnic minority groups. A summary SHS may help monitor sleep health across populations, while measurement of specific sleep components may help identify modifiable targets. Support Joon Chung is supported by a T-32 NIH training grant.

scholarly journals O028 Effectiveness of digital brief behavioural therapy for insomnia with wearable technology: pilot randomized controlled trial

2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A13-A13
Author(s):  
C Gordon ◽  
M Aji ◽  
N Glozier ◽  
D Bartlett ◽  
R Calvo ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Pilot Trial ◽  
Sleep Onset ◽  
Severity Index ◽  
Sleep Time ◽  
Behavioural Therapy ◽  
Wearable Device ◽  
User Engagement ◽  
Sleep Onset Latency ◽  
Significant Difference

Abstract Objective This pilot trial aimed to test the effectiveness of integration of a wearable device with digital brief behavioural therapy for insomnia (dBBTi) on insomnia symptom severity, sleep metrics and therapy engagement. Participants and Methods One hundred and twenty-eight participants with insomnia symptoms were randomised to a 3-week dBBTi program with a wearable device enabling sleep data synchronization (dBBTi+wearable group; n = 62) or dBBTi alone (n = 66). We assessed the Insomnia Severity Index (ISI) and modified Pittsburgh Sleep Quality Index (PSQI; wake-after-sleep-onset (WASO), sleep-onset-latency (SOL), and total sleep time (TST)) at baseline and weeks 1, 2, 3, 6 and 12. Engagement was measured by the number of daily sleep diaries. Results There was no significant difference in ISI scores between the groups (d = 0.7, p = 0.061). The dBBTi+wearable group showed greater improvements in WASO (d = 0.8, p = 0.005) and TST (d = 0.3, p = 0.049) compared to the dBBTi group after 6 weeks. There was significantly greater engagement in the dBBTi+wearable group compared to the dBTi group (d =0.7, p = 0.010). Conclusions This pilot trial found that wearable device integration with a digital insomnia therapy led to improvements in WASO and TST and enhanced user engagement. We suggest that incorporation of adjunctive wearable technologies may improve digital insomnia therapy.

scholarly journals Sleep Parameters in Short Daily versus Conventional Dialysis: An Actigraphic Study

2017 ◽  
Vol 2017 ◽  
pp. 1-6
Author(s):  
Ludimila D’Avila e Silva Allemand ◽  
Otávio Toledo Nóbrega ◽  
Juliane Pena Lauar ◽  
Joel Paulo Russomano Veiga ◽  
Einstein Francisco Camargos
Keyword(s):  
Total Sleep Time ◽  
Linear Regression Analysis ◽  
Sleep Onset ◽  
Objective Measure ◽  
Sleep Time ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Wake Time ◽  
Daily Dialysis ◽  
Sleep Parameters

Previous studies have observed worse sleep quality in patients undergoing conventional dialysis as compared to daily dialysis. Our aim was to compare the sleep parameters of patients undergoing daily or conventional dialysis using an objective measure (actigraphy). This cross-sectional study was performed in three dialysis centers, including a convenience sample (nonprobability sampling) of 73 patients (36 patients on daily hemodialysis and 37 patients on conventional hemodialysis). The following parameters were evaluated: nocturnal total sleep time (NTST), expressed in minutes; wake time after sleep onset (WASO), expressed in minutes; number of nighttime awakenings; daytime total sleep time (DTST), expressed in minutes; number of daytime naps; and nighttime percentage of sleep (% sleep). The Mini-Mental State Examination and the Beck Depression Inventory were also administered. The mean age was 53.4  ±  17.0 years. After adjustment of confounding factors using multiple linear regression analysis, no difference in actigraphy parameters was detected between the groups: NTST (p=0.468), WASO (p=0.88), % sleep (p=0.754), awakenings (p=0.648), naps (p=0.414), and DTST (p=0.805). Different from previous studies employing qualitative analysis, the present assessment did not observe an influence of hemodialysis modality on objective sleep parameters in chronic renal patients.

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 &gt; 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 0954 Sleep of Gifted Children Using Actigraphy

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A362-A363
Author(s):  
L Bastien ◽  
R Théoret ◽  
R Godbout
Keyword(s):  
Normative Data ◽  
Intellectual Development ◽  
Total Sleep Time ◽  
Sleep Onset ◽  
Sleep Time ◽  
Gifted Children ◽  
Typically Developing ◽  
Relational Development ◽  
Wake Time ◽  
Definition Of

Abstract Introduction Intellectual giftedness is characterized by an intellectual development superior to peers (QI &gt; 120) while emotional and relational development corresponds to the age norms. Anecdotal reports from parents suggest that they sleep poorly compared to typically developing (TD) peers. We measured sleep of gifted children using actigraphy. Methods Thirteen gifted children (10 boys, mean age = 10.58, SD = 2.11) were studied. Giftedness was identified using Renzulli’s three-factor definition of giftedness conceptualise in terms of above-average ability and high levels of task commitment (refined or focused form of motivation), and creativity. Sleep was measured with actigraphy for two weeks and compared to normative data from TD children using T-tests. Results Compared to normative data from TD children, gifted children had a significantly shorter sleep latency (p &lt; 0.001), longer sleep periods (p = 0.001), shorter total sleep time and more wake time after sleep onset (p = 0.03). These differences were present both on week nights and weekend nights except that total sleep time was shorter in gifted children only during weekends (p &lt; 0.001). Conclusion These data suggest that gifted children sleep poorly, and more so upon weekends. Whether this correlates with daytime functioning remains to be determined. Support N/A

scholarly journals Training Schedule and Sleep in Adolescent Swimmers

2020 ◽  
Vol 32 (1) ◽  
pp. 16-22
Author(s):  
Sigridur L. Gudmundsdottir
Keyword(s):  
Athletic Performance ◽  
Mixed Models ◽  
Total Sleep Time ◽  
Sleep Onset ◽  
Sleep Time ◽  
Early Morning ◽  
Sleep Efficiency ◽  
Regression Analyses ◽  
Training Schedule ◽  
Early Training

Purpose: Insufficient sleep duration may affect athletic performance and health. Inconsistent sleep pattern also has negative health effects, but studies on athletes’ intraindividual sleep variability are scarce. The aim of this research was to compare total sleep time (TST) and variability (TST-variability), wakening after sleep onset, and sleep efficiency, during nights preceding early morning practices with other nights, and to investigate sleep characteristics of nights following a day with early morning only, evening only, or both a morning and an evening session in adolescent swimmers. Methods: Wrist-worn accelerometers were used to measure 1 week of sleep in 108 swimmers (mean age 16.1 [2.6] y) in Iceland. Adjusted regression analyses and linear mixed models were used to explore associations of training schedules with TST, TST-variability, wakening after sleep onset, and sleep efficiency. Results: Mean TST was 6:32 (h:min) (±39 min) and TST-variability was 63 minutes (±25 min). TST decreased and TST-variability increased with more early morning practices. TST preceding early training was 5:36 and 5:06 in <16- and ≥16-year-olds, respectively, shorter than on nights preceding later or no morning training (P < .001). Conclusion: Swimmers have extremely short TST preceding early morning sessions and increased TST-variability with more early morning sessions.

scholarly journals Sleep maturation influences cognitive development of preterm toddlers

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Akiko Ando ◽  
Hidenobu Ohta ◽  
Yuko Yoshimura ◽  
Machiko Nakagawa ◽  
Yoko Asaka ◽  
...  
Keyword(s):  
Cognitive Development ◽  
Sleep Duration ◽  
Sleep Time ◽  
Brain Maturation ◽  
Sleep Diary ◽  
Sleep Regulation ◽  
Wake Time ◽  
Daytime Nap ◽  
Nighttime Sleep ◽  
The Relationship

AbstractOur recent study on full-term toddlers demonstrated that daytime nap properties affect the distribution ratio between nap and nighttime sleep duration in total sleep time but does not affect the overall total amount of daily sleep time. However, there is still no clear scientific consensus as to whether the ratio between naps and nighttime sleep or just daily total sleep duration itself is more important for healthy child development. In the current study, to gain an answer to this question, we examined the relationship between the sleep properties and the cognitive development of toddlers born prematurely using actigraphy and the Kyoto scale of psychological development (KSPD) test. 101 premature toddlers of approximately 1.5 years of age were recruited for the study. Actigraphy units were attached to their waist with an adjustable elastic belt for 7 consecutive days and a child sleep diary was completed by their parents. In the study, we found no significant correlation between either nap or nighttime sleep duration and cognitive development of the preterm toddlers. In contrast, we found that stable daily wake time was significantly associated with better cognitive development, suggesting that sleep regulation may contribute to the brain maturation of preterm toddlers.

scholarly journals The feasibility and reliability of actigraphy to monitor sleep in intensive care patients: an observational study

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
L. J. Delaney ◽  
E. Litton ◽  
K. L. Melehan ◽  
H.-C. C. Huang ◽  
V. Lopez ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Observational Study ◽  
Total Sleep Time ◽  
Sleep Time ◽  
Moderate Level ◽  
Sleep Monitoring ◽  
Clinical Trial Registration ◽  
Wake Time ◽  
Intensive Care Patients

Abstract Background Sleep amongst intensive care patients is reduced and highly fragmented which may adversely impact on recovery. The current challenge for Intensive Care clinicians is identifying feasible and accurate assessments of sleep that can be widely implemented. The objective of this study was to investigate the feasibility and reliability of a minimally invasive sleep monitoring technique compared to the gold standard, polysomnography, for sleep monitoring. Methods Prospective observational study employing a within subject design in adult patients admitted to an Intensive Care Unit. Sleep monitoring was undertaken amongst minimally sedated patients via concurrent polysomnography and actigraphy monitoring over a 24-h duration to assess agreement between the two methods; total sleep time and wake time. Results We recruited 80 patients who were mechanically ventilated (24%) and non-ventilated (76%) within the intensive care unit. Sleep was found to be highly fragmented, composed of numerous sleep bouts and characterized by abnormal sleep architecture. Actigraphy was found to have a moderate level of overall agreement in identifying sleep and wake states with polysomnography (69.4%; K = 0.386, p < 0.05) in an epoch by epoch analysis, with a moderate level of sensitivity (65.5%) and specificity (76.1%). Monitoring accuracy via actigraphy was improved amongst non-ventilated patients (specificity 83.7%; sensitivity 56.7%). Actigraphy was found to have a moderate correlation with polysomnography reported total sleep time (r = 0.359, p < 0.05) and wakefulness (r = 0.371, p < 0.05). Bland–Altman plots indicated that sleep was underestimated by actigraphy, with wakeful states overestimated. Conclusions Actigraphy was easy and safe to use, provided moderate level of agreement with polysomnography in distinguishing between sleep and wakeful states, and may be a reasonable alternative to measure sleep in intensive care patients. Clinical Trial Registration number ACTRN12615000945527 (Registered 9/9/2015).

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