The Experience of Insomnia in Patients With Schizophrenic Disorder: A Qualitative Study

BackgroundInsomnia is a health problem that particularly affects people with schizophrenia. Its repercussions go beyond the disorder itself and affect many areas of life. The aim of the present study is to explore the clinical symptoms and consequences of insomnia in patients diagnosed with schizophrenic disorder and the perceptions of these patients regarding the care they receive.MethodsThe study takes a qualitative approach and uses semi-structured interviews to conduct a descriptive and interpretive analysis of 3 clinically different clusters of patients. These 3 clusters have been defined by using two-step cluster analysis based on the results of the ISI (Insomnia Severity Index) and EQ-5D scales (EuroQol-5D) and the presence of certain diagnostic symptoms in a sample of 170 patients. The final sample was 31 subjects. The analysis was based on a hermeneutic analysis of the patients' narratives regarding their experiences of insomnia.ResultsThe patients' narratives show differences in the intensity and experience of insomnia depending on the severity, as well as its impact on their quality of life. Insomnia has a huge emotional impact. Participants describe ruminations and obsessive thoughts as a key factor hindering falling asleep. Some of the everyday actions they perform encourage the chronicity of insomnia. The desired health response must include interventions that are effective, such as cognitive-behavioural therapy, and powerful, such as pharmacological solutions. Psychoeducation and advice on sleep hygiene are highly valued tools as preventive strategies.ConclusionsTo know the experience of users gives us a more comprehensive understanding of insomnia complexities and brings some new intervention strategies in patients with mental disorders. It is important that health professionals intervene preventively to stop the disorder from becoming chronic.

Order matters: sleep spindles contribute to memory consolidation only when followed by rapid-eye-movement sleep

Sleep is known to benefit memory consolidation, but little is known about the contribution of sleep stages within the sleep cycle. The sequential hypothesis proposes that memories are first replayed during non-rapid-eye-movement (NREM or N) sleep and then integrated into existing networks during rapid-eye-movement (REM or R) sleep, two successive critical steps for memory consolidation. However, it lacks experimental evidence as N always precedes R sleep in physiological conditions. We tested this sequential hypothesis in patients with central hypersomnolence disorder, including patients with narcolepsy who present the unique, anti-physiological peculiarity of frequently falling asleep in R sleep before entering N sleep. Patients performed a visual perceptual learning task before and after daytime naps stopped after one sleep cycle, starting in N or R sleep and followed by the other stage (i.e. N-R vs. R-N sleep sequence). We compared over-nap changes in performance, reflecting memory consolidation, depending on the sleep sequence during the nap. Thirty-six patients who slept for a total of 67 naps were included in the analysis. Results show that sleep spindles are associated with memory consolidation only when N is followed by R sleep, that is in physiologically ordered N-R naps, thus providing support to the sequential hypothesis in humans. In addition, we found a negative effect of rapid-eye-movements in R sleep on perceptual consolidation, highlighting the complex role of sleep stages in the balance to remember and to forget.

gamified sleep intervention for veterans: an overview

A good night’s sleep is well known to be imperative for maintaining one’s overall wellness. Yet, about half of Canadian adults struggle with falling asleep or maintaining sleep. The impacts of insufficient sleep are wide-ranging, from physiological correlates such as diabetes to mental correlates such as depression. Effective treatments for sleep-related issues exist: for example, online interventions for insomnia have been found to be effective. As a medicine and a health psychology student at, respectively, Sherbrooke University and McGill University, we worked on the MissionVAV health promotion program during the COVID-19 pandemic, providing free gamified interventions for Canadian Veterans and their families. Over the course of several online interventions related to physical health, we observed that a large proportion of our participants were dissatisfied with their sleep. Consequently, we have developed an 8-week online sleep intervention to address this primordial element of primary prevention. The intervention aims to better our participants’ sleep through providing weekly readings on the following topics: age-related changes in sleep, proper sleep hygiene, varied relaxation techniques as well as the relationship between sleep and chronic pain, menopause, shift work, rumination, exercise and light. To promote healthy sleep hygiene habits, daily self-assessment questions are provided and are incentivized through points and storytelling. Furthermore, health coaches trained in sleep medicine follow participants throughout their journey to provide support and reinforcement. Ultimately, the intervention aims to shed light on the importance of sleep within preventative medicine, tackling it systematically in an engaging, gamified fashion.

Effects Of Sleep Paralysis On Human Psychology

Sleep paralysis is a state of consciousness experienced while waking from sleep or falling asleep. It is characterized by an experience of being unable to move for several seconds or minutes. Sleep paralysis entails a period of paralysis upon waking or falling asleep and is often accompanied by terrifying hallucinations. Many stressful environmental factors which cause emotional stress also induce sleep paralysis. In addition to stressful environmental factors being associated with the condition, there appears to be a dominant genetic factor associated with the predisposition for developing sleep paralysis. The implications of these findings for stress, anxiety, and sleep are discussed. Almost three hundred people from various age groups of Karachi city were targeted as the respondents. A multifactor questionnaire was constructed to measure the effects of sleep paralysis – independent variable, and the human psychology – dependent variable. Regression analysis was performed and proposed two models using SPSS. The results of statistical tests were concluded in a way that how sleep paralysis effects a person’s life. The final results showed the effects of sleep paralysis on one’s psychology and personal life.

Effects of Circadian Phase Tailored Light Therapy on Sleep, Mood, and Cognition in Alzheimer’s Disease: Preliminary Findings in a Pivotal Study

It is shown that the circadian system is affected in patients with Alzheimer’s disease (AD) even at an early stage of the disease and that such dysfunction may be detrimental to sleep, mood, and cognitive functioning. Light is a strong central modulator of the circadian rhythms and is potentially beneficial to mood and cognitive functioning via a direct effect or indirectly via its modulating effects on circadian rhythms. This study focuses on tracking the effect of light therapy on sleep quality, mood, and cognition in AD of mild/moderate severity. We performed a single-blind randomized controlled trial to investigate the effects of a light therapy treatment tailored to the individual circadian phase as measured by dim light melatonin onset (DLMO). Such a treatment induced an objective circadian phase shift consistent with the melatonin phase response curve to light exposure, led to a shortening of the phase angle DLMO-falling asleep time, and was associated with an improvement in subjective sleep quality and cognitive performance.

Effects of Anxiety, Depression, and Stress on Sleep Disorder and Night Eating Syndrome in Adolescents: Results of an Internet Survey

PurposeThe current study examined how sleep quality is related to night eating syndrome (NES) via the indirect effects of anxiety, depression, and stress to determine the mechanism of its development. MethodsThis cross-sectional web-based study included 171 adolescents aged 12-18 years (55.0% girls). Participants completed the self-report Night Eating Questionnaire (NEQ), Scales for Outcomes in Parkinson’s disease (SCOPA) Sleep Scale, and Depression, Anxiety and Stress Scale–21 items (DASS-21). ResultsThe results showed that anxiety, depression, and stress directly influenced the NEQ. AMOS path analysis was used to examine whether these also had an indirect influence on the NEQ. Moreover, for the anxiety, depression, and stress subscales, only the anxiety subscale influenced nighttime eating problems due to increased sleep problems, which in turn increased the difficulty of morning sleepiness and falling asleep at night. ConclusionConsequently, depression and stress directly increased nighttime eating problems. Anxiety exacerbates eating problems, both directly and indirectly, through sleep. Behavioral and psychological interventions to reduce anxiety, depression, and stress may be helpful strategies for the treatment of night eating syndrome.Level of evidence: Level IV

Effects Of Sleep Paralysis On Human Psychology

Sleep paralysis is a state of consciousness experienced while waking from sleep or falling asleep. It is characterized by an experience of being unable to move for several seconds or minutes. Sleep paralysis entails a period of paralysis upon waking or falling asleep and is often accompanied by terrifying hallucinations. Many stressful environmental factors which cause emotional stress also induce sleep paralysis. In addition to stressful environmental factors being associated with the condition, there appears to be a dominant genetic factor associated with the predisposition for developing sleep paralysis. The implications of these findings for stress, anxiety, and sleep are discussed. Almost three hundred people from various age groups of Karachi city were targeted as the respondents. A multifactor questionnaire was constructed to measure the effects of sleep paralysis – independent variable, and the human psychology – dependent variable. Regression analysis was performed and proposed two models using SPSS. The results of statistical tests were concluded in a way that how sleep paralysis effects a person’s life. The final results showed the effects of sleep paralysis on one’s psychology and personal life.

Is Yoga Associated With Improved Sleep Amongst Breast Cancer Survivors?

Background Breast cancer survivors may experience sleep disturbances that can affect their physical and mental well-being. We sought to determine the association, if any, between yoga and sleep among breast cancer survivors in a population-based cohort. Methods The National Health Interview Survey is designed to be representative of the US civilian non-institutionalized population. We evaluated breast cancer survivors in the 2017 cohort to determine the association between yoga and self-reported quality of sleep. Results Of the 25,905 people surveyed, representing 238,738,039 in the population, 1.59% reported a previous history of breast cancer. Breast cancer survivors were less likely to report having practiced yoga in the preceding 12 months, compared to those without a history of breast cancer (9.98% vs 13.78%, P = .011). In addition, they were more likely to report having had trouble falling asleep (44.64% vs 36.32%, P = .002), staying asleep (53.72% vs 39.43%, P < .001), and using sleep medication on at least 1 day within the previous week (23.80% vs 13.49%, P < .001) than those without breast cancer. Among breast cancer survivors, there were no significant differences in difficulty falling asleep (39.16% vs 44.98%, P = .482), difficulty staying asleep (61.17% vs 52.70%, P = .305), and needing sleep medication (19.03% vs 24.53%, P = .395) between those who practiced yoga and those who did not. Controlling for sociodemographic factors, there remained no association between yoga and difficulty falling or staying asleep among breast cancer survivors. Conclusion There is no direct association between yoga and sleep quality in breast cancer survivors.

Sleep position, patient comfort, and technical performance with two established procedures for home sleep testing

Purpose In patients with a high pre-test probability of suffering from obstructive sleep apnea (OSA), (cardio)-respiratory polygraphy (RP; level 3) is commonly used for home sleep testing (HST); however, testing based on peripheral arterial tonometry (PAT) is increasingly recognized as an alternative method. The aim of the study was to compare sleep position, patients’ comfort, and technical failure rates of HST with RP and PAT in patients with suspected OSA. Methods Sleep position, patients’ comfort, and technical failure rates of RP and PAT were compared in 56 patients receiving two nights of HST with either RP or PAT in a randomized fashion. Results Time in supine position with PAT was significantly lower (173.7±88 min) compared to RP (181.7±103.7 min; p < 0.001), although the absolute mean difference was not clinically significant. Patients reported to sleep better, feeling less disturbed when falling asleep, losing less sensors, and fewer nightly awakenings with PAT, but experienced more pain at the side of the finger probe. Forty-five out of 56 patients (80%) rated PAT as being the superior sleep test and 49 out of 56 (88%) would prefer PAT for further investigations (p<0.001). PAT testing was associated with less technical failures. Conclusion The results demonstrate that HST with PAT leads to less time in supine sleep positioning, which may be clinically relevant in selected patients. Moreover, PAT is associated with less technical failures and is perceived with less discomfort during testing and a reduced number of nocturnal awakenings in patient self-reports.

Clinical phenomenology of anxiety disorders in internally displaced persons

In recent years, reports from international organizations have focused on the mental health of internally displaced persons and the provision of timely medical care. Involuntary resettlement is accompanied by transformation of the entire system of socio- psychological relations, including interpersonal, family, parental, labor and leads to a significant strain on pathopsychological mechanisms, which ultimately contributes to the formation of anxiety disorders. In examined patients from main group, along with mood depression and anxiety, there were various fears and anxieties, asthenic manifestations and autonomic paroxysms, as well as against the background of anxious symptoms, they noted presence of isolated obsessive fears, closely related to anxious thinking about assessments in the eyes of others, short-term violent reactions to minor emotional events, mismatch of the strength of emotional reactions to the situation. At the same time, patients of the control group showed sensitization to external stimuls, especially during sleep and in the process of falling asleep.