A Novel Group Cognitive Behavioral Therapy Approach to Adult Non-rapid Eye Movement Parasomnias

Background: Following the success of Cognitive Behavioral Therapy (CBT) for insomnia, there has been a growing recognition that similar treatment approaches might be equally beneficial for other major sleep disorders, including non-rapid eye movement (NREM) parasomnias. We have developed a novel, group-based, CBT-program for NREM parasomnias (CBT-NREMP), with the primary aim of reducing NREM parasomnia severity with relatively few treatment sessions.Methods: We investigated the effectiveness of CBT-NREMP in 46 retrospectively-identified patients, who completed five outpatient therapy sessions. The outcomes pre- and post- CBT-NREMP treatment on clinical measures of insomnia (Insomnia Severity Index), NREM parasomnias (Paris Arousal Disorders Severity Scale) and anxiety and depression (Hospital Anxiety and Depression Scale), were retrospectively collected and analyzed. In order to investigate the temporal stability of CBT-NREMP, we also assessed a subgroup of 8 patients during the 3 to 6 months follow-up period.Results: CBT-NREMP led to a reduction in clinical measures of NREM parasomnia, insomnia, and anxiety and depression severities [pre- vs. post-CBT-NREMP scores: P (Insomnia Severity Index) = 0.000054; P (Paris Arousal Disorders Severity Scale) = 0.00032; P (Hospital Anxiety and Depression Scale) = 0.037]. Improvements in clinical measures of NREM parasomnia and insomnia severities were similarly recorded for a subgroup of eight patients at follow-up, demonstrating that patients continued to improve post CBT-NREMP.Conclusion: Our findings suggest that group CBT-NREMP intervention is a safe, effective and promising treatment for NREM parasomnia, especially when precipitating and perpetuating factors are behaviorally and psychologically driven. Future randomized controlled trials are now required to robustly confirm these findings.

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Interpreting softmax predictions of sleep stage classification models

10.36227/techrxiv.16722403 ◽

2021 ◽

Author(s):

Iris Huijben ◽

Lieke WA Hermans ◽

Allessandro C Rossi ◽

Sebastiaan Overeem ◽

Merel M van Gilst ◽

...

Keyword(s):

Sleep Stage ◽

Depression Scale ◽

Severity Index ◽

Anxiety And Depression ◽

Hospital Anxiety ◽

Exclusion Criteria ◽

Stage Classification ◽

Sleep Stage Classification ◽

Somatic Disorders ◽

Insomnia Severity

<div>We used a dataset of nocturnal PSG recordings, collected as part of the Healthbed study, which main aim was development of technologies for sleep analyses. The dataset includes one clinical video-PSG recording for each subject, made according to the AASM recommendations in Sleep Medicine Center Kempenhaeghe Heeze, the Netherlands. The study included 96 (60 females) healthy subjects, with an age between 18 and 64. The exclusion criteria were: 1) any diagnosed sleep disorder, 2) a Pittsburgh Sleep Quality Index >= 6, or Insomnia Severity Index > 7, 3) indication of depression or anxiety disorder measured with the Hospital Anxiety and Depression Scale (score > 8), 4) pregnancy, shift work, use of any medication except for birth control medicine, and 5) presence of clinically relevant neurological or psychiatric disorders or other somatic disorders that could influence sleep.</div>

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Interpreting softmax predictions of sleep stage classification models

10.36227/techrxiv.16722403.v1 ◽

2021 ◽

Author(s):

Iris Huijben ◽

Lieke WA Hermans ◽

Allessandro C Rossi ◽

Sebastiaan Overeem ◽

Merel M van Gilst ◽

...

Keyword(s):

Sleep Stage ◽

Depression Scale ◽

Severity Index ◽

Anxiety And Depression ◽

Hospital Anxiety ◽

Exclusion Criteria ◽

Stage Classification ◽

Sleep Stage Classification ◽

Somatic Disorders ◽

Insomnia Severity

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Changes in insomnia as a risk factor for the incidence and persistence of anxiety and depression: a longitudinal community study

Sleep Science and Practice ◽

10.1186/s41606-020-00053-z ◽

2021 ◽

Vol 5 (1) ◽

Author(s):

Magnus Johansson ◽

Markus Jansson-Fröjmark ◽

Annika Norell-Clarke ◽

Steven J. Linton

Keyword(s):

Risk Factor ◽

Depression Scale ◽

Binary Logistic Regression ◽

Anxiety And Depression ◽

Hospital Anxiety ◽

Dynamic Risk ◽

Increased Risk ◽

Longitudinal Association ◽

Development Of Anxiety

Abstract Background The aim of this investigation was to examine the longitudinal association between change in insomnia status and the development of anxiety and depression in the general population. Methods A survey was mailed to 5000 randomly selected individuals (aged 18–70 years) in two Swedish counties. After 6 months, a follow-up survey was sent to those (n = 2333) who answered the first questionnaire. The follow-up survey was completed by 1887 individuals (80.9%). The survey consisted of questions indexing insomnia symptomatology, socio-demographic parameters, and the Hospital Anxiety and Depression Scale. Change in insomnia status was assessed by determining insomnia at the two time-points and then calculating a change index reflecting incidence (from non-insomnia to insomnia), remission (from insomnia to non-insomnia), or status quo (no change). Multivariate binary logistic regression analyses were used to examine the aim. Results Incident insomnia was significantly associated with an increased risk for the development of new cases of both anxiety (OR = 0.32, p < .05) and depression (OR = 0.43, p < .05) 6 months later. Incident insomnia emerged also as significantly associated with an elevated risk for the persistence of depression (OR = 0.30, p < .05), but not for anxiety. Conclusions This study extends previous research in that incidence in insomnia was shown to independently increase the risk for the development of anxiety and depression as well as for the maintenance of depression. The findings imply that insomnia may be viewed as a dynamic risk factor for anxiety and depression, which might have implications for preventative work.

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Cognitive Behavioral Therapy for Functional Dysphonia: A Pilot Study

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348940711601002 ◽

2007 ◽

Vol 116 (10) ◽

pp. 717-722 ◽

Cited By ~ 17

Author(s):

Paressa Daniilidou ◽

Paul Carding ◽

Janet Wilson ◽

Michael Drinnan ◽

Vincent Deary

Keyword(s):

Psychological Distress ◽

Behavioral Therapy ◽

General Health Questionnaire ◽

Depression Scale ◽

Voice Therapy ◽

Anxiety And Depression ◽

Health Questionnaire ◽

Hospital Anxiety ◽

Language Therapist ◽

Functional Dysphonia

Objectives: We sought to investigate whether a brief period of training in cognitive behavioral therapy (CBT) can improve the treatment of functional dysphonia by a speech and language therapist and ameliorate the psychological distress associated with this condition. Methods: In a consecutive cohort design, a speech and language therapist treated a small cohort (n = 15) of dysphonic patients with voice therapy alone. After a brief period of CBT training, she treated the next cohort of dysphonic patients (n = 13) with CBT-enhanced voice therapy. Pretreatment and posttreatment measures were taken of voice quality and voice-related quality of life. The General Health Questionnaire 28 and the Hospital Anxiety and Depression Scale were used to assess psychological distress and general well-being. Results: All voice measures improved significantly in both cohorts. Both groups improved significantly on the General Health Questionnaire 28, with the CBT group improving significantly more than the control group. Only the CBT group improved significantly on the Hospital Anxiety and Depression Scale (depression subscale). Conclusions: Despite limitations of size, design, and between-group baseline differences, the results support the hypothesis that the addition of CBT skills to existing voice therapy is both feasible and clinically effective in the treatment of functional dysphonia.

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Higher Self-Esteem Associated With Less Symptoms of Anxiety and Depression Among Young Adults After the Loss of a Parent to Cancer—A Longitudinal Study

Journal of Palliative Care ◽

10.1177/08258597211044585 ◽

2021 ◽

pp. 082585972110445

Author(s):

Tina Lundberg ◽

Kristofer Årestedt ◽

Ulla Forinder ◽

Mariann Olsson ◽

Carl Johan Fürst ◽

...

Keyword(s):

Young Adults ◽

Support Group ◽

Depression Scale ◽

Self Esteem ◽

Anxiety And Depression ◽

Linear Regression Models ◽

Hospital Anxiety ◽

Parentally Bereaved ◽

Loss Of A Parent

Objective: The purpose of the study was to examine associations between self-esteem and symptoms of anxiety and depression among young adults who lost a parent to cancer. Methods: Older adolescents and young adults, aged 16 to 28 years, who had lost their parent to cancer and had accepted an invitation to join a support group, completed a questionnaire 5 to 8 months after the loss and a similar questionnaire about 10 months later (follow-up). Of a total of 77 young adults who participated in the study, 56 completed both questionnaires. Self-esteem was measured with the Rosenberg Self-Esteem Scale. Symptoms of anxiety and depression were measured with the Hospital Anxiety and Depression Scale. Univariate and multiple linear regression models were used to analyze the associations. Result: Self-esteem was significantly associated with symptoms of anxiety and depression at baseline and at follow-up. Conclusion: This study reveals that self-esteem is a valuable explanatory variable, and that it is associated with both symptoms of anxiety and depression in bereavement. This new knowledge could be used to guide future support to parentally bereaved young adults.

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Frequency and characteristics of drowsiness, somnolence, or daytime sleepiness in patients with advanced cancer

Palliative & Supportive Care ◽

10.1017/s1478951518000779 ◽

2018 ◽

Vol 17 (04) ◽

pp. 459-463 ◽

Cited By ~ 2

Author(s):

Sriram Yennurajalingam ◽

Srikanth Reddy Barla ◽

Joseph Arthur ◽

Gary B. Chisholm ◽

Eduardo Bruera

Keyword(s):

Quality Index ◽

Pittsburgh Sleep Quality Index ◽

Depression Scale ◽

Well Being ◽

Severity Index ◽

Hospital Anxiety ◽

Hospital Anxiety Depression Scale ◽

Clinically Significant ◽

Anxiety Depression ◽

Insomnia Severity

AbstractIntroductionCancer-related drowsiness (CRD) is a distressing symptom in advanced cancer patients (ACP). The aim of this study was to determine the frequency and factors associated with severity of CRD. We also evaluated the screening performance of Edmonton Symptom Assessment Scale-drowsiness (ESAS-D) item against the Epworth Sedation Scale (ESS).MethodWe prospectively assessed 180 consecutive ACP at a tertiary cancer hospital. Patients were surveyed using ESAS, ESS, Pittsburgh Sleep Quality Index, Insomnia Severity Index, and Hospital Anxiety Depression Scale.ResultNinety of 150 evaluable patients had clinically significant CRD (ESS); median (interquartile ratio): ESS. 11 (7–14); ESAS-D. 5 (2–6); Pittsburgh Sleep Quality Index. 8 (5–11); Insomnia Severity Index. 13 (5–19); Stop Bang Scoring 3 (2–4), and Hospital Anxiety Depression Scale-D 6 (3–10). ESAS-D was associated with ESAS (r, p) sleep (0.38, <0.0001); pain (0.3, <0.0001); fatigue (0.51, <0.0001); depression (0.39, <0.0001); anxiety (0.44, <0.0001); shortness of breath (0.32, <0.0001); anorexia (0.36, <0.0001), feeling of well-being [(0.41, <0.0001), ESS (0.24, 0.001), and opioid daily dose (0.19, 0.01). Multivariate-analysis showed ESAS-D was associated with fatigue (odds ratio [OR] = 9.08, p < 0.0001), anxiety (3.0, p = 0.009); feeling of well-being (OR = 2.27, p = 0.04), and insomnia (OR = 2.35; p = 0.036). Insomnia (OR = 2.35; p = 0.036) cutoff score ≥3 (of 10) resulted in a sensitivity of 81% and 32% and specificity of 70% and 44% in the training and validation samples, respectively.Significance of resultsClinically significant CRD is frequent and seen in 50% of ACP. CRD was associated with severity of insomnia, fatigue, anxiety, and worse feeling of well-being. An ESAS-D score of ≥3 is likely to identify most of the ACP with significant CRD.

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Predictors of Emotional Distress and Wellbeing 2–5 Years After Stroke

ISRN Stroke ◽

10.1155/2013/467398 ◽

2013 ◽

Vol 2013 ◽

pp. 1-7 ◽

Cited By ~ 2

Author(s):

H. Bergersen ◽

A.-K. Schanke ◽

K. S. Sunnerhagen

Keyword(s):

Emotional Distress ◽

General Health Questionnaire ◽

Depression Scale ◽

Well Being ◽

Anxiety And Depression ◽

Independent Mobility ◽

Hospital Anxiety ◽

Gender Education ◽

Comprehensive Rehabilitation

Objectives. To identify predictors of emotional distress and psychological wellbeing in stroke survivors 2–5 years after discharge from comprehensive rehabilitation. Material and Methods. The Hospital Anxiety and Depression Scale (HADS), the General Health Questionnaire (GHQ-30), and questions regarding life situations were mailed to former patients. Multiple regression analyses were performed. Results. The responses from 68 participants (37% women), of an average age of 58 years old, were used. Emotional distress (HADS > 10) was identified in 41%. Well-being (GHQ-30 < 6) was identified in 46%. Not surprisingly, there was a strongly negative association between well-being (GHQ-30 < 6) and emotional distress (HADS > 10) at follow up. Dependency in toileting during rehabilitation predicted emotional distress 2–5 years later. Finally, well-being at followup was predicted by age > 65 years, independent mobility, perceiving proxies as supportive, and being in employment. Conclusions. Dependence in the activities of daily living 3–6 months after-injury predicted emotional distress 2–5 years after-stroke. Being over 65 years, having an occupation, proxy support and being less dependent all predicted well-being. Emotional distress and well-being were clearly negatively associated. Gender, education, marital status, and type of stroke were not associated with the outcome measures.

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Long-Term Follow-Up of Disability, Cognitive, and Emotional Impairments after Severe Traumatic Brain Injury

Behavioural Neurology ◽

10.1155/2019/9216931 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Britt-Marie Stålnacke ◽

Britt-Inger Saveman ◽

Maud Stenberg

Keyword(s):

Cognitive Function ◽

Clinical Course ◽

Depression Scale ◽

Anxiety And Depression ◽

Hospital Anxiety ◽

Emotional Impairments ◽

Long Term Follow Up ◽

Severe Tbi

Aim. To assess the clinical course of disability, cognitive, and emotional impairments in patients with severe TBI (s-TBI) from 3 months to up to 7 years post trauma.Methods. A prospective cohort study of s-TBI in northern Sweden was conducted. Patients aged 18-65 years with acute Glasgow Coma Scale 3-8 were assessed with the Glasgow Outcome Scale Extended (GOSE), the Hospital Anxiety and Depression Scale (HADS), and the Barrow Neurological Institute Screen for Higher Cerebral Functions (BNIS) at 3 months, 1 year, and 7 years after the injury.Results. The scores on both GOSE and BNIS improved significantly from 3 months (GOSE mean:4.4±2.3, BNIS mean:31.5±7.0) to 1 year (GOSE mean:5.5±2.7,p=0.003, BNIS mean:33.2±6.3,p=0.04), but no significant improvement was found from 1 year to 7 years (GOSE mean:4.7±2.8,p=0.13, BNIS mean:33.5±3.9,p=0.424) after the injury. The BNIS subscale “speech/language” at 1 year was significantly associated with favourable outcomes on the GOSE at 7 years (OR=2.115, CI: 1.004-4.456,p=0.049).Conclusions. These findings indicate that disability and cognition seem to improve over time after s-TBI and appear to be relatively stable from 1 year to 7 years. Since cognitive function on some of the BNIS subscales was associated with outcome on the GOSE, these results indicate that both screening and follow-up of cognitive function could be of importance for the rehabilitation of persons with s-TBI.

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Longitudinal comparison of anxiety and depression between idiopathic pulmonary fibrosis and other interstitial lung diseases: a prospective cohort study

10.21203/rs.3.rs-36517/v1 ◽

2020 ◽

Author(s):

Won Bae ◽

Jaeyoung Cho ◽

Jinwoo Lee ◽

Young Sik Park ◽

Chang-Hoon Lee ◽

...

Keyword(s):

Idiopathic Pulmonary Fibrosis ◽

Pulmonary Fibrosis ◽

Odds Ratio ◽

Lung Diseases ◽

Depression Scale ◽

Interstitial Lung Diseases ◽

Anxiety And Depression ◽

Hospital Anxiety ◽

St George's Respiratory Questionnaire

Abstract Background and objective: Few studies have investigated the differences in the incidence of anxiety and depression among the interstitial lung diseases (ILDs). We evaluated the differences in the incidence of anxiety and depression between idiopathic pulmonary fibrosis (IPF) and non-IPF ILD, and the changes after a 1-year follow-up period. Methods The study participants were patients included in a prospective ILD cohort of Seoul National University Hospital between March 2013 and August 2018. Clinical variables were recorded at baseline and at 1 year. The Hospital Anxiety and Depression Scale was used to assess patient anxiety and depression at baseline and at 1-year follow-up. Results A total of 224 patients in the cohort participated in the study (154 [68.8%] with IPF and 70 [31.2%] with non-IPF ILD). Among them, 111 patients completed a follow-up Hospital Anxiety and Depression Scale questionnaire 1 year later (77 in the IPF group, 34 in the non-IPF group). In the IPF group, 20.8% and 27.3% of patients suffered from anxiety and 29.9% and 31.2% suffered from depression at baseline and 1-year follow-up, respectively. In the non-IPF group, 14.3% and 23.5% of patients suffered from anxiety and 24.3% and 17.6% suffered from depression at baseline and 1-year follow-up, respectively. Total score on the St. George’s Respiratory Questionnaire at baseline was associated with depression both at baseline (odds ratio 1.05; 95% confidence interval 1.02–1.08) and at 1-year follow-up (odds ratio 1.03; 95% confidence interval 1.00-1.05), even after adjusting other factors. The interaction of prevalence change of anxiety and depression at baseline and 1-year follow-up between the IPF group and the non-IPF ILD group were not statistically significant (p-value 0.878 for anxiety and 0.376 for depression, respectively). Conclusion The prevalence of anxiety and depression at baseline and at 1-year follow-up were not significantly different between patients with IPF and non-IPF ILD. St. George’s Respiratory Questionnaire total score at baseline was associated with depression at baseline and at 1-year follow-up.

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1126 Relationship Between Headache and Sleep: A Longitudinal Study from the Population of Sao Paulo City (Brazil)

SLEEP ◽

10.1093/sleep/zsaa056.1120 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A428-A429

Author(s):

L M Lucchesi ◽

P F Tempaku ◽

A A Smith ◽

S Togeiro ◽

H Hachul ◽

...

Keyword(s):

Longitudinal Study ◽

Sleep Disturbances ◽

Severity Index ◽

Sao Paulo ◽

Anxiety And Depression ◽

São Paulo ◽

Follow Up Studies ◽

Nocturnal Awakening ◽

Insomnia Severity

Abstract Introduction The complaint of nocturnal awakening with headache (NAH), was prevalent (8.4%) in the São Paulo population and was associated with sleep disturbances, as demonstrated in a study conducted in 2007 (EPISONO). Indeed, this relationship between sleep and headache is well documented in the literature. Objective: To assess the incidence and evolution of NAH and to associate sleep-related variables in an eight-year prospective study. Methods From 1042 volunteers enrolled in the baseline, 712 agreed to participate in the follow-up. Questionnaires and scales were applied and polysomnography and actigraphy performed. The complaint of NAH was analyzed according to a frequency questionnaire and separated into frequent or occasional. Results At follow-up, 110 volunteers reported NAH, of which 82 were the same as those from the baseline, but only 38 had frequent complaints. Comparing with volunteers whose headache has become occasional, we have as a difference the insomnia severity index which is significantly higher in the group with frequent NAH (8.40 ± 5.10 vs 11.20±6.40 p:0.03) and worse sleep quality as measured by the Pittsburgh questionnaire (7.25±3.60 vs 10.25±4.60 p:0.002). In addition, these volunteers had higher anxiety (10.40±9.30 vs 12.00± 10:00 p: 0.008) and depression (10.60±9.90 vs 12:00±9.90 p:0.005) from Beck’s questionnaires and greater fatigue (4.85±3.10 vs 9.75±5.55 p:0.001). The associations of NAH with insomnia, nightmares, and bruxism observed in the baseline continued, but no difference was observed between those who had frequent or occasional complaints at follow-up. Conclusion Our study showed that NAH was highly prevalent in the Sao Paulo population in both the baseline and follow-up studies, but this frequency had a reduction in follow-up. Volunteers who persisted with the frequent complaint showed greater severity of insomnia, higher anxiety and depression and greater fatigue. Support Associação Fundo de Incentivo à Pesquisa (AFIP) and São Paulo Research Foundation (FAPESP)

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