scholarly journals Yoga nidra practice shows improvement in sleep in patients with chronic insomnia: A randomized controlled trial

2021 ◽  
Vol 34 ◽  
pp. 143-150
Author(s):  
KARUNA DATTA ◽  
MANJARI TRIPATHI ◽  
MANSI VERMA ◽  
DEEPIKA MASIWAL ◽  
HRUDA NANDA MALLICK
Keyword(s):  
Sleep Quality ◽  
Salivary Cortisol ◽  
Controlled Trial ◽  
Sleep Onset ◽  
Sleep Time ◽  
Chronic Insomnia ◽  
Sleep Diary ◽  
Subjective Sleep Quality ◽  
Subjective Sleep ◽  
Yoga Nidra

Background Yoga nidra is practised by sages for sleep. The practice is simple to use and has been clearly laid out, but its role in the treatment of chronic insomnia has not been well studied. Methods In this randomized parallel-design study conducted during 2012–16, we enrolled 41 patients with chronic insomnia to receive conventional intervention of cognitive behavioural therapy for insomnia (n=20) or yoga nidra (n=21). Outcome measures were both subjective using a sleep diary and objective using polysomnography (PSG). Salivary cortisol levels were also measured. PSG was done before the intervention in all patients and repeated only in those who volunteered for the same. Results Both interventions showed an improvement in subjective total sleep time (TST), sleep efficiency, wake after sleep onset, reduction in total wake duration and enhancement in subjective sleep quality. Objectively, both the interventions improved TST and total wake duration and increased N1% of TST. Yoga nidra showed marked improvement in N2% and N3% in TST. Salivary cortisol reduced statistically significantly after yoga nidra (p=0.041). Conclusion Improvement of N3 sleep, total wake duration and subjective sleep quality occurred following yoga nidra practice. Yoga nidra practice can be used for treatment of chronic insomnia after supervised practice sessions.

scholarly journals Effect of kidney transplantation on sleep quality in patients admitted in ICU:a cross-section study in China

2019 ◽  
Author(s):  
Lu Long ◽  
Jia Liu ◽  
Jin Yan ◽  
Jian fei Xie ◽  
Huan Liu ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Sleep Quality ◽  
Linear Regression Analysis ◽  
Sleep Onset ◽  
Sleep Time ◽  
Middle Level ◽  
Sleep Disruption ◽  
Poor Sleep ◽  
Subjective Sleep Quality ◽  
Subjective Sleep

Abstract Background Although evidences showed that sleep disorder is common in patient with end stage renal disease (ESRD), less is known about their sleep quality after early post-kidney transplantation (kTx) especially in Intensive Care Unite (ICU). Thus, the purpose of this study is to investigate sleep quality of kTx recipients in ICU and explore factors related poor sleep, second, to measure the correlation of subjective sleep quality and sleep architecture assessed by PSG in kTx recipients. Methods This study recruited participants from ESRD patients registered in transplantation waiting list at the third xiangya hospital of central south university in China. Participants required to complete the Pittsburgh sleep quality index(PSQI) and demographic questionnaire as baseline data and received one night of Polysomnography (PSG) in the ICU within 96 hours of surgery, during which time sound and light data were monitored. After that Richards Campbell sleep questionnaires (RCSQ) also need completed. Results 26 participants self-reported sleep quality and sleep efficiency based on RCSQ was at middle level (49.2 ± 25.6mm), and 14/26(53.8%) kTx recipients in ICU were poor sleepers defined by RCSQ <50. PSG showed that most kTx recipients in ICU had shallow sleep with mainly stage 2 sleep time (80.90 ±70.10 min), lower total sleep time (136.50 ±86.41 min), higher awakening frequency after sleep onset (8.87 ±5.92 times) and long awaken time (94.67 ±75.09 min) when a sleep disruption occured. multiple linear regression analysis showed that self-reported noise and pain were the significant factor affecting sleep(P < 0.05).Conclusion Subjective sleep quality based on RCSQ scored better than objective one measured by PSG in kTx recipients, sleep disruption always remained a substantial problem and affected by self-reported noise and pain.

scholarly journals The serotonin transporter gene-linked polymorphic region (5-HTTLPR) and the sleep-promoting effects of tryptophan: A randomized placebo-controlled crossover study

2019 ◽  
Vol 33 (8) ◽  
pp. 948-954
Author(s):  
Jens H van Dalfsen ◽  
C Rob Markus
Keyword(s):  
Sleep Quality ◽  
Allelic Variation ◽  
Sleep Onset ◽  
Treatment Protocol ◽  
Sleep Diary ◽  
Transporter Gene ◽  
Subjective Sleep Quality ◽  
Subjective Sleep ◽  
Allele Group ◽  
S Allele

Background:The low-expressive short (S) allele of a functional polymorphism (5-HTTLPR) within the serotonin (5-hydroxytriptamine; 5-HT) transporter gene (SLC6A4) has been associated with a reduced functioning of the brain 5-HT system relative to the long (L) allele. As a consequence, the S-allele is found to predispose individuals to a higher risk of sleep quality reduction and clinical insomnia.Aims:The present study investigated whether subchronic pre-sleep tryptophan administration could compensate for this predisposition by improving sleep in 5-HTTLPR S-allele carriers.Methods:In a double-blind placebo-controlled crossover design a sample of homozygous 5-HTTLPR S-allele ( n = 47) and L-allele ( n = 51) carriers were assessed for subjective (sleep diary) and objective (actigraphy) sleep during a treatment protocol consisting of 1 week of placebo (1000 mg/day) and 1 week of tryptophan administration (1000 mg/day).Results:The results support the sleep-promoting effects of tryptophan. Tryptophan improved objective sleep efficiency and objective wake after sleep onset irrespective of allelic variation. There was a marginally significant improvement of subjective sleep quality in the 5-HTTLPR S-allele group but not in the L-allele group following tryptophan relative to placebo intake. In contrast, a significantly poorer sleep quality in the S-allele as opposed to the L-allele group in the placebo condition was not observed in the tryptophan condition.Conclusions:Tryptophan augmentation promises to be a valuable treatment strategy for sleep impairments related to genetic deficiencies in 5-HT functioning.

scholarly journals Relationship between Cortisol Changes during the Night and Subjective and Objective Sleep Quality in Healthy Older People

2020 ◽  
Vol 17 (4) ◽  
pp. 1264
Author(s):  
Matias M. Pulopulos ◽  
Vanesa Hidalgo ◽  
Sara Puig-Perez ◽  
Teresa Montoliu ◽  
Alicia Salvador
Keyword(s):  
Sleep Quality ◽  
Older People ◽  
Hpa Axis ◽  
Sleep Onset ◽  
Quality Data ◽  
Sleep Diary ◽  
Subjective Sleep Quality ◽  
Sleep Quantity ◽  
Subjective Sleep ◽  
Subjective Socioeconomic Status

The aim of this study was to investigate whether the nighttime cortisol release was associated with subjective and objective sleep quality and the discrepancy between them. Forty-five healthy older adults (age range from 56 to 75 years) collected salivary samples immediately before sleep and immediately after awakening on two consecutive nights. Actigraphy was used to assess objective sleep quality and quantity. A sleep diary was used to assess subjective sleep quality. Linear mixed models were performed using subjective and objective sleep quality data from 76 nights to investigate between-subject associations. We observed that larger changes in cortisol levels between sleep onset and awakening, reflecting a healthier circadian rhythm of the Hypothalamic-Pituitary-Adrenal (HPA) axis, were associated with better subjective sleep quality, but not with objective sleep quality. Moreover, smaller changes in nighttime cortisol were associated with lower subjective sleep quality relative to objective sleep quality. All these results were observed even after controlling for important confounders such as sleep quantity, age, sex, subjective socioeconomic status, stress perception, depression, physical activity, and adherence to the salivary sampling protocol. This study demonstrates that subjective sleep quality in older people may be explained, to some extent, by the activity of the HPA axis.

The Effect of Uncoupled Sleep and Dysfunctional Sleep Beliefs on Sleep Outcomes in Older Adults following Online Cognitive Behavioral Therapy for Insomnia: A Single-Group Non-randomized Trial (Preprint)

2021 ◽  
Author(s):  
Yvonne Kutzer ◽  
Lisa Whitehead ◽  
Eimear Quigley ◽  
Shih Ching Fu ◽  
Mandy Stanley
Keyword(s):  
Older Adults ◽  
Cognitive Behavioral Therapy ◽  
Sleep Quality ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Behavioral Therapy ◽  
Sleep Onset ◽  
Poor Sleep ◽  
Subjective Sleep Quality ◽  
Subjective Sleep

BACKGROUND The current Covid-19 pandemic has brought about a marked interest in sleep health, as well as an increased demand for telehealth services, such as online Cognitive Behavioral Therapy for insomnia (CBT-I). Older adults in particular report a high rate of sleep problems. Recent studies have suggested that dysfunctional sleep beliefs could contribute to the high rates of self-reported insomnia in this age group. In addition, older adults have an increased rate of uncoupled sleep, e.g. displaying an insomnia complaint in the absence of objectively measured poor sleep. It is essential to determine the prevalence of coupled and uncoupled sleep in older adults and to examine the efficacy of online CBT-I to improve sleep outcomes. OBJECTIVE This study aims to assess objective and subjective sleep quality and dysfunctional sleep beliefs in a sample of community-dwelling older adults aged 60-80 years with and without uncoupled sleep in Western Australia following digitally delivered CBT-I. METHODS Objective sleep was measured using wrist actigraphy, and subjective sleep quality via sleep diaries and the Pittsburgh Sleep Quality Index (PSQI). Dysfunctional sleep beliefs were assessed by the Dysfunctional Beliefs and Attitudes about Sleep scale (DBAS-16) prior to and following a four-week online CBT-I programme. Linear mixed model and generalised linear mixed model analyses were conducted to examine objective and subjective sleep onset latency, total sleep time, wake after sleep onset and number of awakenings as well as PSQI and DBAS16 scores, respectively. RESULTS 62 participants (55 females; 88.7%) completed the study. CBT-I effectively reduced dysfunctional sleep beliefs and PSQI scores across all sleep classifications, even in good sleepers without a sleep complaint. Objective and self-reported changes in sleep parameters were mainly demonstrated in complaining poor sleepers. Complaining good sleepers reported a decrease in the number of subjective sleep awakenings only. CONCLUSIONS Online CBT-I was effective in improving the sleep outcomes of individuals who had both subjective and objective poor sleep. However, as the online CBT-I reduced dysfunctional sleep beliefs in all sleep groups, further examination of dysfunctional sleep beliefs and whether they mediate the outcomes of digital CBT-I in older adults will need to be conducted. CLINICALTRIAL Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN 12619001509156; http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378451 INTERNATIONAL REGISTERED REPORT RR2-32705

scholarly journals 0845 The Difference in Sleep Characteristics of Chronic Insomnia Disorder According to Gender and Age

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A322-A322
Author(s):  
J Hong ◽  
H Lee ◽  
I Yoon
Keyword(s):  
Sleep Quality ◽  
The Elderly ◽  
Sleep Time ◽  
Chronic Insomnia ◽  
Middle Aged ◽  
Subjective Sleep ◽  
Time In Bed ◽  
Insomnia Disorder ◽  
Gender And Age ◽  
Sleep Parameters

Abstract Introduction Impacts of age and gender on sleep have been reported in normal population, but rarely in chronic insomnia disorder (CID). This study aimed to investigate difference in sleep characteristics of CID according to gender and age. Methods The participants with drug-naïve CID and aged between 40 and 79 years were recruited. We compared subjective and objective sleep parameters between the middle-aged (40-64 years, N=86) and the elderly (65-79 years, N=50), and between men (N=45) and women (N=91). The subjective sleep quality and habitual sleep time were measured by Pittsburgh Sleep Quality Index (PSQI). The participants were asked to wear an actigraph for 4 days to obtain objective sleep parameters. Results In the PSQI, the elderly reported earlier bedtime and wake-up time (p=0.018; p=0.026), reduced total sleep time (TST) and sleep efficiency (p=0.003; p=0.011), and low sleep quality (p=0.034) compared to the middle-aged. However, according to the actigraphy, differences were observed only in the bedtime (p=0.016) and the wake-up time (p=0.002) between the two age groups. Between genders, the actigraphy showed that the male patients woke up earlier than the female group (p=0.015); except for this finding, there was no significant gender effect. Meanwhile, regarding gender and age interactions, the elderly women with CID showed longer time in bed (TIB) with increase in both TST and wake after sleep onset (WASO) compared to the middle-aged women. The elderly men showed decreased TIB and TST, and slightly decreased WASO than the middle-aged men. Conclusion The elderly with CID show more subjective sleep complaints than the middle-aged CID despite little difference in objective sleep characteristics, which suggests that the elderly CID may seek medical help more than the middle aged. As women with CID get older, they increase time spent in bed to maintain sleep time, but with resultant increase in wake. Support None

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&lt;.0001), WASO (-17.8 min [-23.4, -12.3]; p&lt;.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&lt;.0001) and sleep quality (0.41 [0.30, 0.53]; p&lt;.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 Adults Consuming an Energy-Restricted US Healthy-Style Eating Pattern at Either the Recommended or a Higher Protein Quantity Perceive a Shift from “Poor” to “Good” Sleep

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 528-528
Author(s):  
Joshua Hudson ◽  
Jing Zhou ◽  
Wayne Campbell
Keyword(s):  
Sleep Quality ◽  
Dietary Protein ◽  
Sleep Onset ◽  
Sleep Onset Latency ◽  
Quality Indices ◽  
Subjective Sleep Quality ◽  
Eating Pattern ◽  
Subjective Sleep ◽  
Good Sleep ◽  
Over Time

Abstract Objectives Limited evidence from secondary analyses suggests consuming a higher protein diet during weight loss improves subjective indices of sleep in adults who are overweight and obese. We sought to a priori assess the effects consuming a U.S. Healthy–Style Eating Pattern with the recommended versus a higher amount of protein and moderate energy-restriction on sleep quality indices. Methods Using of a randomized, parallel-design, 51 men and women (mean ± SEM; age: 47 ± 1 y; BMI: 32.6 ± 0.5 kg/m2) consumed a controlled U.S. Healthy-Style Eating Pattern containing 750 kcal/d less than their estimated energy requirement for 12 wk. The additional dietary protein (7.5 oz-eq/d) came from animal-based protein sources and displaced primarily whole and reined grains. Objective and subjective sleep quality indices were measured using wrist-worn actigraphy and questionnaires (Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale), respectively, at pre-, mid- (week 6), and post-intervention (week 12). Results Among all participants, body mass decreased (-6.2 ± 0.4 kg). Dietary protein intake did not affect any of the objective or subjective sleep quality outcomes measured. Over time, objective measures of time spend in bed, time spent sleeping, sleep efficiency, sleep onset latency, and time awake after sleep onset did not change. Subjective measures of global sleep score (GSS, −3.8 ±0.4 au) and daytime sleepiness score (−3.8 ± 0.4 au; both P &lt; 0.001) improved over time. The GSS improvement transitioned the group of participants from being categorized with a poor to a good sleep condition (GSS &gt;5 versus ≤5 au of 0–21 au scale; Pre 7.9 ± 0.5 au, Post: 4.0 ± 0.6 au). Conclusions Although objective sleep quality may not improve, adults with poor sleep may perceive becoming good sleepers while consuming a moderately energy-restricted U.S. Healthy-Style Eating Pattern containing either the recommended or a higher amount of protein. Funding Sources The Beef Checkoff and American Egg Board-Egg Nutrition Center.

Effectiveness of a Multicomponent Group Treatment for Insomnia

1995 ◽  
Vol 23 (2) ◽  
pp. 109-127 ◽  
Author(s):  
Elisabeth Schramm ◽  
Fritz Hohagen ◽  
Jutta Backhaus ◽  
Stefanie Lis ◽  
Mathias Berger
Keyword(s):  
Sleep Quality ◽  
Group Treatment ◽  
Psychological Treatment ◽  
Sleep Onset ◽  
Sleep Diary ◽  
Management Problem ◽  
Sleep Onset Latency ◽  
Subjective Sleep Quality ◽  
Significant Treatment ◽  
Problem Solving Skills

The present study evaluates a multifaceted cognitive-behavioral group treatment in a routine clinical setting. The program consists of directly sleep related strategies such as sleep education, sleep restriction, stimulus control, relaxation, and cognitive restructuring. Also included are techniques that target illness maintaining factors such as stress-management, problem solving skills, and increase of activities. Twenty-eight physician-referred outpatients with chronic primary insomnia according to DSM-III-R criteria attended 11 weekly therapy-sessions. Results were obtained on a subjective and objective level using a sleep diary, questionnaires, and polysomnography, respectively. Pre- and post-treatment comparisons indicated significant changes on all main sleep diary variables, i.e. total sleep time, sleep efficiency, number of awakenings, sleep onset latency and wake after sleep onset, as well as for the global subjective sleep quality. Maximum improvement was reached after the more directly sleep-related part of the program. In addition, the intervention helped patients to reduce the amount and frequency of sleeping aids over time and improved their daytime-functioning. Subjective therapeutic gains were maintained at 3- and 12-month follow-ups. No significant treatment effects could be obtained on polysomnographic measures, taking into account that the baseline values were already in the normative range. After the intervention the patients were able to give a more realistic evaluation of their sleep. These results suggest that a multicomponent psychological treatment is beneficial for the improvement of sleep quality on a subjective level.

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