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Digestive Diseases and Sciences Jun 2023Poor sleep may be prospectively associated with worse disease course in inflammatory bowel disease (IBD). Chronic insomnia is the most common cause of poor sleep...
BACKGROUND AND AIMS
Poor sleep may be prospectively associated with worse disease course in inflammatory bowel disease (IBD). Chronic insomnia is the most common cause of poor sleep complaints in IBD and is theorized to be maintained by dysfunctional thoughts and behavioral patterns. However, data characterizing patterns specific to insomnia in IBD are lacking. Understanding the nuances of insomnia and patients' preferences for treatment is critical for addressing this significant comorbidity in IBD.
METHODS
We conducted an anonymous, mixed-method online survey of people with IBD and asked questions about sleep patterns, thoughts, and behaviors related to sleep, treatment preferences, and barriers to treatment.
RESULTS
312 participants (60.9% Crohn's, 66.3% women, mean age of 48.62 years) were included in this study. Participants with insomnia were significantly more concerned about the consequences of sleep loss, felt more helpless about their sleep, and were more likely to engage in behaviors known to perpetuate insomnia (e.g., spending time in bed in pain; ps ≤ 0.001) than those without insomnia. 70.3% of participants were interested in discussing sleep as part of IBD care, 63.5% were interested in receiving sleep recommendations from their gastroenterologist, and 84.6% of those with insomnia were interested in participating in sleep treatments.
CONCLUSION
Participants with IBD and insomnia are interested in treatment and reported patterns that can be targeted in Cognitive Behavioral Therapy for Insomnia, as opposed to traditional sleep hygiene guidelines. Additionally, people with insomnia engaged in several sleep-interfering behaviors related to pain. Clinical trials that target insomnia in people with IBD should include pain management in the intervention.
Topics: Humans; Female; Middle Aged; Male; Sleep Initiation and Maintenance Disorders; Gastroenterologists; Inflammatory Bowel Diseases; Pain; Sleep; Colitis, Ulcerative
PubMed: 36840812
DOI: 10.1007/s10620-023-07883-8 -
CNS Spectrums Jun 2010Insomnia symptoms, which are common in depression, have a significant impact on function and quality of life. However, little is known about the prevalence and...
INTRODUCTION
Insomnia symptoms, which are common in depression, have a significant impact on function and quality of life. However, little is known about the prevalence and associated features of insomnia symptoms in representative treatment-seeking patients with depression.
METHODS
Data from the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial were analyzed. STAR*D recruited 3,743 adult outpatients diagnosed with nonpsychotic major depressive disorder (MDD) from primary (n=18) and psychiatric care (n=23) clinics across the United States. Baseline sociodemographic and clinical features were compared between those with insomnia symptoms (84.7%) and those without (15.3%).
RESULTS
The most common presentation was the simultaneous presence of sleep onset, mid-nocturnal, and early morning insomnia symptoms (27.1%). Of these three types of insomnia symptoms, mid-nocturnal insomnia symptoms were the most commonly found alone (13.5%) and in combination with one or more other types (82.3%). Insomnia symptoms were associated with several indicators of a more severe depressive illness. Only a small proportion of participants with insomnia symptoms were receiving treatment for sleep disturbances at study initiation, and the vast majority of those receiving treatment still reported having insomnia symptoms.
CONCLUSION
In outpatients who seek treatment for nonpsychotic MDD in typical clinical settings, insomnia symptoms are very common, undertreated, and indicative of a more severe depression.
Topics: Adolescent; Adult; Aged; Depression; Female; Humans; Male; Middle Aged; Outpatients; Psychiatric Status Rating Scales; Psychometrics; Quality of Life; Retrospective Studies; Sleep Initiation and Maintenance Disorders; Socioeconomic Factors; United States; Young Adult
PubMed: 20625372
DOI: 10.1017/s1092852900029266 -
Australasian Journal on Ageing Sep 2018To measure the prevalence of insomnia and identify the socio-economic correlates of insomnia among older people of Anhui Province of China.
OBJECTIVE
To measure the prevalence of insomnia and identify the socio-economic correlates of insomnia among older people of Anhui Province of China.
METHODS
A cross-sectional study was conducted among 3045 randomly selected consenting residents aged 60 and older from Anhui Province during 2013. Insomnia was assessed using the Athens Insomnia Scale (AIS). Data collected included: (i) demographics; (ii) socio-economic status; (iii) social support; (iv) social contact; and (v) social capital.
RESULTS
Overall, 24% were found to have insomnia and 9% were found to have suspected insomnia according to the AIS score. After adjusting for potential confounders, participants having no fixed income, less social contact, less social capital and living alone were more likely to suffer from insomnia.
CONCLUSIONS
A high prevalence of insomnia was found among older people in Anhui Province of China. Socio-economic determinants should be addressed in devising policies aimed at improving sleep quality for older people in this region.
Topics: Age Factors; Aged; Aged, 80 and over; China; Cross-Sectional Studies; Female; Health Surveys; Humans; Income; Interpersonal Relations; Male; Middle Aged; Prevalence; Risk Factors; Single Person; Sleep; Sleep Initiation and Maintenance Disorders; Social Capital; Social Support; Socioeconomic Factors
PubMed: 30175542
DOI: 10.1111/ajag.12531 -
Journal of Advanced Nursing Jun 2005This paper reports a systematic review of seven studies evaluating the efficacy of cognitive behavioural therapy (CBT) for persistent primary insomnia. (Review)
Review
AIM
This paper reports a systematic review of seven studies evaluating the efficacy of cognitive behavioural therapy (CBT) for persistent primary insomnia.
BACKGROUND
Insomnia is one of the most common health complaints reported in the primary care setting. Although non-pharmacological treatments such as the CBT have been suggested to be useful in combating the persistent insomnia, the efficacy and clinical utility of CBT for primary insomnia have yet to be determined.
METHOD
A systematic search of Ovid, MEDLINE, psychINFO, PsycARTICLES, CINAHL, and EMBASE databases of papers published between 1993 and 2004 was conducted, using the following medical subject headings or key words: insomnia, primary insomnia, psychophysiological insomnia, sleep maintenance disorders, sleep initiation disorders, non-pharmacological treatment, and cognitive behavioural therapy. A total of seven papers was included in the review.
FINDINGS
Stimulus control, sleep restriction, sleep hygiene education and cognitive restructuring were the main treatment components. Interventions were provided by psychiatrists except for one study, in which the CBT was delivered by nurses. Among beneficial outcomes, improvement of sleep efficacy, sleep onset latency and wake after sleep onset were the most frequently reported. In addition, participants significantly reduced sleep medication use. Some studies gave follow-up data which indicated that the CBT produced durable clinical changes in total sleep time and night-time wakefulness.
CONCLUSIONS
These randomized controlled trial studies demonstrated that CBT was superior to any single-component treatment such as stimulus control, relaxation training, educational programmes, or other control conditions. However, heterogeneity in patient assessment, CBT protocols, and outcome indicators made determination of the relative efficacy and clinical utility of the therapy difficult. Therefore, the standard components of CBT need to be clearly defined. In addition, a comprehensive assessment of patients is essential for future studies.
Topics: Adult; Cognitive Behavioral Therapy; Female; Humans; Male; Middle Aged; Primary Health Care; Sleep; Sleep Initiation and Maintenance Disorders; Time Factors; Treatment Outcome
PubMed: 15882372
DOI: 10.1111/j.1365-2648.2005.03433.x -
Journal of Sleep Research Sep 2011The type and severity of daytime symptoms reported by insomnia sufferers may vary markedly. Whether distinctive daytime symptom profiles are related to different...
The type and severity of daytime symptoms reported by insomnia sufferers may vary markedly. Whether distinctive daytime symptom profiles are related to different insomnia diagnoses has not been studied previously. Using profile analysis via multidimensional scaling, we investigated the concurrent validity of ICSD-2 insomnia diagnoses by analysing the relationship of prototypical profiles of daytime symptoms with a subset of ICSD-2 diagnoses, such as insomnia associated to a mental disorder, psychophisiological insomnia, paradoxical insomnia, inadequate sleep hygiene, idiopathic insomnia, obstructive sleep apnea and restless legs syndrome. In a sample of 332 individuals meeting research diagnostic criteria for insomnia (221 women, M(age) =46 years.), the profile analysis identified four prototypical patterns of daytime features. Pearson correlation coefficients indicated that the diagnoses of insomnia associated to a mental disorder and idiopathic insomnia were associated with a daytime profile characterized by mood disturbance and low sleepiness; whereas the diagnoses of psychophysiological insomnia and inadequate sleep hygiene were related to a profile marked by poor sleep hygiene, daytime tension and low fatigue. Furthermore, whereas paradoxical insomnia was consistently associated to lower daytime impairment, insomnia associated to a mental disorder appeared as the most severe daytime form of insomnia. This classification of insomnia sufferers along multiple defining dimensions provides initial validation for two basic insomnia subtypes, with a presumably distinct aetiology: insomnia characterized mainly by an 'internal' component, and a 'learned' insomnia. Research to determine which dimensions are critical for inclusion or differential weighting for defining a general typological system for insomnia sufferers is warranted.
Topics: Adult; Depression; Fatigue; Female; Humans; Male; Middle Aged; Sleep Initiation and Maintenance Disorders; Wakefulness
PubMed: 21205038
DOI: 10.1111/j.1365-2869.2010.00905.x -
Journal of Mental Health (Abingdon,... Feb 2020: While it has been demonstrated that dysfunctional sleep beliefs can contribute to sleep disturbances, less is known about it in psychiatric patients and the role these...
: While it has been demonstrated that dysfunctional sleep beliefs can contribute to sleep disturbances, less is known about it in psychiatric patients and the role these beliefs play in influencing sleep.: To examine maladaptive sleep cognition among psychiatric patients and to assess its association with insomnia.: Participants were outpatients ( = 400) recruited from a tertiary psychiatric hospital. The Dysfunctional Beliefs and Attitudes about Sleep (DBAS-16) scale was administered to examine sleep-related cognitions in different domains. Clinical insomnia was assessed using the Insomnia Severity Index. Factors associated with DBAS were explored using linear regression and the association between DBAS scores and insomnia was tested using logistic regression.: Among psychiatric patients, factors associated with the DBAS domains were ethnicity, educational attainment, psychiatric comorbidity, and consumption of sleep medication. Higher dysfunctional sleep beliefs were associated with insomnia. The association was particularly prominent in the mood disorder diagnostic group.: Dysfunctional sleep beliefs were associated with insomnia among psychiatric patients. Addressing these maladaptive cognitions is critical in alleviating sleep problems in psychiatric patients.
Topics: Adult; Aged; Attitude to Health; Female; Humans; Male; Mental Disorders; Middle Aged; Outpatients; Severity of Illness Index; Sleep Initiation and Maintenance Disorders; Surveys and Questionnaires; Young Adult
PubMed: 29707991
DOI: 10.1080/09638237.2018.1466046 -
Journal of Psychiatric Research 2003Insomnia is frequent in the general population and is often related to a psychiatric illness. However, little is known about how the chronicity of insomnia affects this... (Comparative Study)
Comparative Study
BACKGROUND
Insomnia is frequent in the general population and is often related to a psychiatric illness. However, little is known about how the chronicity of insomnia affects this relation and how often subjects with chronic insomnia have antecedents of psychiatric disorders.
METHODS
A total of 14,915 subjects aged from 15 to 100 years representative of the general population of the United Kingdom, Germany, Italy, and Portugal were interviewed by telephone using the Sleep-EVAL system. The questionnaire assessed current psychiatric disorders according to the DSM-IV classification and a series of questions assessed the psychiatric history. Insomnia was considered as chronic when it lasted for 6 months or more.
RESULTS
The prevalence for insomnia accompanied with impaired daytime functioning was 19.1% and significantly increased with age. More than 90% of these subjects had a chronic insomnia. About 28% of subjects with insomnia had a current diagnosis of mental disorders and 25.6% had a psychiatric history. A DSM-IV insomnia disorder was found in 6.6% of the sample. Presence of severe insomnia, diagnosis of primary insomnia or insomnia related to a medical condition, and insomnia that lasted more than one year were predictors of a psychiatric history. In most cases of mood disorders, insomnia appeared before (> 40%) or in the same time (> 22%) than mood disorder symptoms. When anxiety disorders were involved, insomnia appeared mostly in the same time (>38%) or after (> 34%) the anxiety disorder.
CONCLUSIONS
The study shows that psychiatric history is closely related to the severity and chronicity of current insomnia. Moreover, chronic insomnia can be a residual symptom of a previous mental disorder and put these subjects to a higher risk of relapse.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anxiety Disorders; Chronic Disease; Cross-Sectional Studies; Depressive Disorder; Diagnosis, Differential; Diagnostic and Statistical Manual of Mental Disorders; Europe; Female; Health Surveys; Humans; Interviews as Topic; Male; Middle Aged; Prevalence; Sleep Initiation and Maintenance Disorders; Surveys and Questionnaires; Time Factors
PubMed: 12482465
DOI: 10.1016/s0022-3956(02)00052-3 -
Behavioral Sleep Medicine 2005In this study, we extended previous research by concentrating on sleep- and grief-related symptoms in a cohort of bereaved college students, in view of the potential for...
In this study, we extended previous research by concentrating on sleep- and grief-related symptoms in a cohort of bereaved college students, in view of the potential for each of these problems to exacerbate the other. A sample of 815 college students completed the Inventory of Complicated Grief (H. G. Prigerson & S. C. Jacobs, 2001), along with an assessment of diagnostic criteria for insomnia and associated sleep behaviors. As predicted, the rate of insomnia was significantly higher (22%) in the bereaved sample than in a nonbereaved comparison group (17%), a difference that was particularly pronounced in terms of middle insomnia. Also as hypothesized, bereaved insomniacs reported higher complicated grief scores than bereaved noninsomniacs, and several specific sleep variables (including sleep-onset insomnia related to nighttime rumination about the loss and sleep-maintenance insomnia associated with dreaming of the deceased) were significantly related to complicated grief symptomatology.
Topics: Adolescent; Adult; Bereavement; Cause of Death; Cohort Studies; Cross-Sectional Studies; Diagnostic and Statistical Manual of Mental Disorders; Dreams; Female; Grief; Homicide; Humans; Male; Sleep Initiation and Maintenance Disorders; Students; Suicide; Surveys and Questionnaires
PubMed: 15802260
DOI: 10.1207/s15402010bsm0302_4 -
Psychiatry Research Jul 2017Because some evidence favors the hyperarousal model of insomnia, we sought to learn more about the dynamics of this phenomenon during sleep. Polysomnographic data from...
Because some evidence favors the hyperarousal model of insomnia, we sought to learn more about the dynamics of this phenomenon during sleep. Polysomnographic data from 30 normative subjects and 86 untreated primary insomnia sufferers recruited from the database of the sleep laboratory were studied for whole nights and in terms of thirds of the night. Untreated primary insomnia sufferers had an increased sleep latency and excess of WASO, together with a deficit in REM and NREM sleep during the entire night. In terms of thirds of the night, they presented a major excess of WASO during the first and last thirds of the night but an excess of lesser importance during the middle third. A deficit in SWS was found during the first third of the night, but for REM, the deficit was present during both the first and last thirds. Primary insomnia sufferers had no SWS or REM deficit during the second third of the night. We found that the hyperarousal phenomenon occurs mainly during the sleep-onset period of the first and last thirds of the night and is less important during the middle third. These results open new avenues for understanding the pathophysiology of primary insomnia.
Topics: Adolescent; Adult; Aged; Arousal; Case-Control Studies; Female; Humans; Male; Middle Aged; Polysomnography; Sleep; Sleep Initiation and Maintenance Disorders; Young Adult
PubMed: 28364590
DOI: 10.1016/j.psychres.2017.03.045 -
Atencion Primaria Nov 2014Insomnia is the most common sleep disorder. In Portugal, teachers have a specific socioeconomic situation, caused by the distance between home and workplace, unstable... (Observational Study)
Observational Study
INTRODUCTION
Insomnia is the most common sleep disorder. In Portugal, teachers have a specific socioeconomic situation, caused by the distance between home and workplace, unstable job situation and students' behavioral problems. The aim of this study was to determine the prevalence of insomnia in a sample of Portuguese schoolteachers.
PARTICIPANTS AND METHODS
In a cross-sectional study 604 teachers were assessed of seventeen public schools, from the districts of Aveiro and Viseu, Portugal. Data was collected through a self-administered questionnaire. Insomnia had been defined according to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) as the presence of one or more of the following symptoms: a) difficulty initiating sleep; b) difficulty maintaining sleep; c) early morning awakening and difficulty getting back to sleep; d) non-restorative sleep, that lasts for a period of 1 month.
RESULTS
Prevalence of insomnia symptoms in the sample was 40.6%. Prevalence of the variables difficulty initiating sleep, difficulty maintaining sleep, early morning awakening and difficulty getting back to sleep and non-restorative sleep were 14.3%, 28.7%, 19.7% and 20.7%, respectively. Insomnia symptoms had been associated with marital status (divorced; OR=1.65; 95%CI, 0.78-3.48), years of teaching experience (10 to 20 years; OR=0.46; 95%CI, 0.28-0.75) and job satisfaction (OR=0.74; 95%CI, 0.53-1.0).
CONCLUSION
Portuguese schoolteachers show a high prevalence of insomnia. Insomnia was associated with sociodemographic and occupational variables.
Topics: Adult; Cross-Sectional Studies; Diagnostic and Statistical Manual of Mental Disorders; Female; Humans; Male; Middle Aged; Portugal; Prevalence; School Teachers; Sleep Initiation and Maintenance Disorders
PubMed: 25476047
DOI: 10.1016/S0212-6567(14)70077-0