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Sleep Initiation and Maintenance Disorders: HELP
Articles by Julienne E. Bower
Based on 5 articles published since 2009
(Why 5 articles?)

Between 2009 and 2019, Julienne Bower wrote the following 5 articles about Sleep Initiation and Maintenance Disorders.
+ Citations + Abstracts
1 Article Tai Chi Chih Compared With Cognitive Behavioral Therapy for the Treatment of Insomnia in Survivors of Breast Cancer: A Randomized, Partially Blinded, Noninferiority Trial. 2017

Irwin, Michael R / Olmstead, Richard / Carrillo, Carmen / Sadeghi, Nina / Nicassio, Perry / Ganz, Patricia A / Bower, Julienne E. ·All authors: University of California Los Angeles, Los Angeles, CA. ·J Clin Oncol · Pubmed #28489508.

ABSTRACT: Purpose Cognitive behavioral therapy for insomnia (CBT-I) and Tai Chi Chih (TCC), a movement meditation, improve insomnia symptoms. Here, we evaluated whether TCC is noninferior to CBT-I for the treatment of insomnia in survivors of breast cancer. Patients and Methods This was a randomized, partially blinded, noninferiority trial that involved survivors of breast cancer with insomnia who were recruited from the Los Angeles community from April 2008 to July 2012. After a 2-month phase-in period with repeated baseline assessment, participants were randomly assigned to 3 months of CBT-I or TCC and evaluated at months 2, 3 (post-treatment), 6, and 15 (follow-up). Primary outcome was insomnia treatment response-that is, marked clinical improvement of symptoms by the Pittsburgh Sleep Quality Index-at 15 months. Secondary outcomes were clinician-assessed remission of insomnia; sleep quality; total sleep time, sleep onset latency, sleep efficiency, and awake after sleep onset, derived from sleep diaries; polysomnography; and symptoms of fatigue, sleepiness, and depression. Results Of 145 participants who were screened, 90 were randomly assigned (CBT-I: n = 45; TCC: n = 45). The proportion of participants who showed insomnia treatment response at 15 months was 43.7% and 46.7% in CBT-I and TCC, respectively. Tests of noninferiority showed that TCC was noninferior to CBT-I at 15 months ( P = .02) and at months 3 ( P = .02) and 6 ( P < .01). For secondary outcomes, insomnia remission was 46.2% and 37.9% in CBT-I and TCC, respectively. CBT-I and TCC groups showed robust improvements in sleep quality, sleep diary measures, and related symptoms (all P < .01), but not polysomnography, with similar improvements in both groups. Conclusion CBT-I and TCC produce clinically meaningful improvements in insomnia. TCC, a mindful movement meditation, was found to be statistically noninferior to CBT-I, the gold standard for behavioral treatment of insomnia.

2 Article Sleep quality and depressive symptoms after prostate cancer: The mechanistic role of cortisol. 2016

Hoyt, Michael A / Bower, Julienne E / Irwin, Michael R / Weierich, Mariann R / Stanton, Annette L. ·Department of Psychology, Graduate Center, Hunter College, City University of New York. · Department of Psychology, Cousins Center for Psychoneuroimmunology, Semel Institute, University of California, Los Angeles. ·Behav Neurosci · Pubmed #26820589.

ABSTRACT: A substantial portion of men treated for prostate cancer report clinically significant sleep problems and disturbance in sleep quality constitutes significant risk for the development of depressive symptoms in survivors. Dysregulation in biological stress processes underlies the impact of poor sleep on the onset and/or progression of depressive symptoms, yet few studies have sought to identify potential neurobiological mechanisms (e.g., HPA axis activation) underlying this association in PC survivors. The present study examines the relationships between sleep disturbance, depressive symptoms, and indices of diurnal cortisol patterns among men treated for prostate cancer. In total, 66 men (84.8% White; mean age = 65.8 years, SD = 9.04) treated in the prior 2 years for localized prostate cancer were recruited. They completed questionnaires to measure sleep quality and depressive symptoms at study entry (T1) and 4 months later (T2). They also provided 4 saliva samples per day, over 3 days, at T1. Three cortisol indices were computed: diurnal slope, area under the curve (AUCg), and cortisol awakening response (CAR). Analyses indicate that, controlling for body mass index and age, worse sleep quality at T1 was significantly associated with higher levels of depressive symptoms at T2. Significant indirect effects were observed for cortisol slope (indirect effect = -.17, 95% CI [-.61, -.01]) and AUCg (indirect effect = -.14, 95% CI [-.43, -.01]), but not CAR. Results suggest that dysregulation in HPA activity acts as a neurobiological mechanism of the impact of sleep disruption on depressive symptoms in men with prostate cancer. (PsycINFO Database Record

3 Article Tai chi, cellular inflammation, and transcriptome dynamics in breast cancer survivors with insomnia: a randomized controlled trial. 2014

Irwin, Michael R / Olmstead, Richard / Breen, Elizabeth C / Witarama, Tuff / Carrillo, Carmen / Sadeghi, Nina / Arevalo, Jesusa M G / Ma, Jeffrey / Nicassio, Perry / Ganz, Patricia A / Bower, Julienne E / Cole, Steve. ·Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience, Los Angeles, CA (MRI, RO, ECB, TW, CC, NS, JMGA, JM, PN, JEB, SC) · Department of Psychiatry and Biobehavioral Sciences (MRI, RO, ECB, JMGA, JM, PN, JEB, SC), and Department of Medicine (JMGA, PAG, SC), UCLA David Geffen School of Medicine, Los Angeles, CA · Division of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA (PAG) · Division of Cancer Prevention and Control Research, UCLA Jonsson Comprehensive Cancer Center, Los Angeles, CA (MRI, PAG, JEB, SC) · Department of Psychology, UCLA, Los Angeles, CA (MRI, JEB). ·J Natl Cancer Inst Monogr · Pubmed #25749595.

ABSTRACT: BACKGROUND: Mind-body therapies such as Tai Chi are widely used by breast cancer survivors, yet effects on inflammation are not known. This study hypothesized that Tai Chi Chih (TCC) would reduce systemic, cellular, and genomic markers of inflammation as compared with cognitive behavioral therapy for insomnia (CBT-I). METHODS: In this randomized trial for the treatment of insomnia, 90 breast cancer survivors with insomnia were assigned to TCC or CBT-I for 2-hour sessions weekly for 3 months. At baseline and postintervention, blood samples were obtained for measurement of C-reactive protein and toll-like receptor-4-activated monocyte production of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF), with a random subsample (n = 48) analyzed by genome-wide transcriptional profiling. RESULTS: Levels of C-reactive protein did not change in the TCC and CBT-I groups. Levels of toll-like receptor-4-activated monocyte production of IL-6 and TNF combined showed an overall reduction in TCC versus CBT-I (P < .02), with similar effects for IL-6 (P = .07) and TNF (P < .05) alone. For genome-wide transcriptional profiling of circulating peripheral blood mononuclear cells, expression of genes encoding proinflammatory mediators showed an overall reduction in TCC versus CBT-I (P = .001). TELiS promoter-based bioinformatics analyses implicated a reduction of activity of the proinflammatory transcription factor, nuclear factor-κB, in structuring these differences. CONCLUSIONS: Among breast cancer survivors with insomnia, 3 months of TCC reduced cellular inflammatory responses, and reduced expression of genes encoding proinflammatory mediators. Given the link between inflammation and cancer, these findings provide an evidence-based molecular framework to understand the potential salutary effects of TCC on cancer survivorship.

4 Article Cancer-related intrusive thoughts predict behavioral symptoms following breast cancer treatment. 2014

Dupont, Alexandra / Bower, Julienne E / Stanton, Annette L / Ganz, Patricia A. ·Department of Psychology, University of California. · UCLA School of Medicine. ·Health Psychol · Pubmed #23379385.

ABSTRACT: OBJECTIVE: Behavioral symptoms are common in breast cancer survivors, including disturbances in energy, sleep, and mood, though few risk factors for these negative outcomes have been identified. Our study examined intrusive thoughts as a predictor of lingering symptoms in breast cancer survivors in the year following treatment. METHOD: Data come from the Moving Beyond Cancer psychoeducational intervention trial, aimed at easing the transition from patient to survivor. Women (n = 558) completed psychosocial questionnaires within 4 weeks posttreatment and again 2, 6, and 12 months later. We examined intrusive thoughts about cancer at the baseline assessment as a predictor of fatigue, sleep problems, pain, breast cancer-specific symptoms, depressive symptoms, negative affect, and quality of life using growth curve modeling, controlling for study condition and other covariates. RESULTS: Intrusive thoughts were associated with higher levels of all symptoms at baseline and at the 12-month assessment. Intrusive thoughts also influenced the trajectory of pain, depressive symptoms, negative affect, and physical functioning over time; women with higher intrusions at baseline started worse and improved over time, whereas those with lower intrusions remained at a constant, lower level over time. Intrusions were not associated with the trajectory of fatigue, sleep, breast cancer-specific symptoms, or mental functioning; women with higher intrusions at baseline started worse and remained worse over time. CONCLUSION: Intrusive thoughts are associated with enduring elevations in behavioral symptoms and impaired quality of life in the year after breast cancer treatment and may be a risk factor for poor outcomes.

5 Article Disrupted sleep in breast and prostate cancer patients undergoing radiation therapy: the role of coping processes. 2010

Thomas, Kamala S / Bower, Julienne / Hoyt, Michael A / Sepah, Saviz. ·Department of Psychology, Pitzer College, Claremont, CA 91711, USA. kamala_thomas@pitzer.edu ·Psychooncology · Pubmed #19885853.

ABSTRACT: BACKGROUND: Sleep problems are a common complaint in cancer patients that have been understudied. METHODS: This study examined changes in sleep in 33 breast cancer (BC) patients and 23 prostate cancer (PC) patients during radiation therapy and over a 6-month followup. Coping processes were examined as predictors of sleep. Self-reported sleep was assessed at eight time-points before, during, and after treatment using the Medical Outcomes Study-Sleep Scale. The COPE Scale was used to assess coping processes before treatment onset. RESULTS: Mixed effects linear modeling analyses revealed that both BC and PC patients reported the most sleep problems prior to and during the early weeks of treatment. Coping strategies predicted sleep trajectories in both groups. In particular, approach coping predicted better sleep in PC patients, whereas avoidance coping predicted worst sleep in both PC and BC patients (p's<0.05). CONCLUSION: These findings highlight the importance of evaluating sleep in patients as they undergo treatment for cancer. Additionally, they suggest that interventions aimed at increasing the use of approach-oriented coping strategies may improve sleep and quality of life in these patients.