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Sleep Initiation and Maintenance Disorders: HELP
Articles by Dr. Allison Harvey
Based on 39 articles published since 2009
(Why 39 articles?)
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Between 2009 and 2019, Allison Harvey wrote the following 39 articles about Sleep Initiation and Maintenance Disorders.
 
+ Citations + Abstracts
Pages: 1 · 2
1 Editorial Obligate symbiosis: sleep and affect. 2010

Walker, Matthew P / Harvey, Allison G. · ·Sleep Med Rev · Pubmed #20427211.

ABSTRACT: -- No abstract --

2 Review Insomnia disorder. 2015

Morin, Charles M / Drake, Christopher L / Harvey, Allison G / Krystal, Andrew D / Manber, Rachel / Riemann, Dieter / Spiegelhalder, Kai. ·Université Laval, École de psychologie, 2325 rue des Bibliothèques, Québec City, Québec G1V 0A6, Canada. · Henry Ford Hospital Sleep Disorders and Research Center, Detroit, Michigan, USA. · Department of Psychology, University of California, Berkeley, Berkeley, California, USA. · Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA. · Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, USA. · Department of Clinical Psychology and Psychophysiology/Sleep Medicine, Center for Mental Disorders, University of Freiburg Medical Center, Freiburg, Germany. ·Nat Rev Dis Primers · Pubmed #27189779.

ABSTRACT: Insomnia disorder affects a large proportion of the population on a situational, recurrent or chronic basis and is among the most common complaints in medical practice. The disorder is predominantly characterized by dissatisfaction with sleep duration or quality and difficulties initiating or maintaining sleep, along with substantial distress and impairments of daytime functioning. It can present as the chief complaint or, more often, co-occurs with other medical or psychiatric disorders, such as pain and depression. Persistent insomnia has been linked with adverse long-term health outcomes, including diminished quality of life and physical and psychological morbidity. Despite its high prevalence and burden, the aetiology and pathophysiology of insomnia is poorly understood. In the past decade, important changes in classification and diagnostic paradigms have instigated a move from a purely symptom-based conceptualization to the recognition of insomnia as a disorder in its own right. These changes have been paralleled by key advances in therapy, with generic pharmacological and psychological interventions being increasingly replaced by approaches that have sleep-specific and insomnia-specific therapeutic targets. Psychological and pharmacological therapies effectively reduce the time it takes to fall asleep and the time spent awake after sleep onset, and produce a modest increase in total sleep time; these are outcomes that correlate with improvements in daytime functioning. Despite this progress, several challenges remain, including the need to improve our knowledge of the mechanisms that underlie insomnia and to develop more cost-effective, efficient and accessible therapies.

3 Review Insomnia as a transdiagnostic process in psychiatric disorders. 2014

Dolsen, Michael R / Asarnow, Lauren D / Harvey, Allison G. ·Department of Psychology, University of California, Berkeley, 2205 Tolman Hall #1650, Berkeley, CA, 94720-1650, USA. ·Curr Psychiatry Rep · Pubmed #25030972.

ABSTRACT: Insomnia is a major public health concern, and is highly comorbid with a broad range of psychiatric disorders. Although insomnia has historically been considered a symptom of other disorders, this perspective has shifted. Epidemiological and experimental studies suggest that insomnia is related to the onset and course of several psychiatric disorders. Furthermore, several randomized controlled trials show that cognitive behavioral therapy for insomnia delivered to individuals who meet diagnostic criteria for insomnia and another psychiatric disorder improves the insomnia as well as the symptoms of the comorbid psychiatric disorder. Taken together, these results encompassing a range of methodologies have provided encouraging evidence and point toward insomnia as a transdiagnostic process in psychiatric disorders.

4 Review Circadian rhythms and psychiatric illness. 2013

Asarnow, Lauren D / Soehner, Adriane M / Harvey, Allison G. ·University of California, Berkeley, California, USA. ·Curr Opin Psychiatry · Pubmed #24060916.

ABSTRACT: PURPOSE OF REVIEW: The present review provides a conceptual introduction to sleep and circadian research in psychiatric illness, and discusses recent experimental and intervention findings in this area. RECENT FINDINGS: In this review, studies published since January 2011 on circadian disturbance and psychiatric illness have been summarized. SUMMARY: Exciting new results have increasingly utilized objective and validated instruments to measure the circadian system in experimental studies. Since 2011, treatment research has still predominantly utilized self-report measures as outcome variables. However, research in the treatment domain for sleep/circadian disturbances comorbid with psychiatric illness has advanced the field in its work to broaden the validation of existing sleep treatments to additional patient populations with comorbid sleep/circadian disruptions and address how to increase access to and affordability of treatment for sleep and circadian dysfunction for patients with psychiatric disorders, and how to combine psychosocial treatments with psychopharmacology to optimize treatment outcomes.

5 Review The complex role of sleep in adolescent depression. 2012

Clarke, Greg / Harvey, Allison G. ·Kaiser Permanente Center for Health Research, 3800 North Interstate Avenue, Portland, OR 97227, USA. Greg.Clarke@kpchr.org ·Child Adolesc Psychiatr Clin N Am · Pubmed #22537732.

ABSTRACT: Psychological and pharmacologic treatments for youth depression yield post-acute response and remission rates that are modest at best. Improving these outcomes is an important long-term goal. The authors examine the possibility that a youth cognitive behavioral therapy insomnia intervention may be an adjunct to traditional depression-focused treatment with the aim of improving depression outcomes. This “indirect route” to improving youth depression treatment outcomes is based on research indicating that the risk of depression is increased by primary insomnia and that sleep problems interfere with depression treatment success and on emerging adult depression randomized controlled trial results. The authors describe the protocol they developed.

6 Review (Mis)perception of sleep in insomnia: a puzzle and a resolution. 2012

Harvey, Allison G / Tang, Nicole K Y. ·Department of Psychology, University of California, Berkeley, 3210 Tolman Hall, Berkeley, CA 94720-1650, USA. aharvey@berkeley.edu ·Psychol Bull · Pubmed #21967449.

ABSTRACT: Insomnia is prevalent, causing severe distress and impairment. This review focuses on illuminating the puzzling finding that many insomnia patients misperceive their sleep. They overestimate their sleep onset latency (SOL) and underestimate their total sleep time (TST), relative to objective measures. This tendency is ubiquitous (although not universal). Resolving this puzzle has clinical, theoretical, and public health importance. There are implications for assessment, definition, and treatment. Moreover, solving the puzzle creates an opportunity for real-world applications of theories from clinical, perceptual, and social psychology as well as neuroscience. Herein we evaluate 13 possible resolutions to the puzzle. Specifically, we consider the possible contribution, to misperception, of (1) features inherent to the context of sleep (e.g., darkness); (2) the definition of sleep onset, which may lack sensitivity for insomnia patients; (3) insomnia being an exaggerated sleep complaint; (4) psychological distress causing magnification; (5) a deficit in time estimation ability; (6) sleep being misperceived as wake; (7) worry and selective attention toward sleep-related threats; (8) a memory bias influenced by current symptoms and emotions, a confirmation bias/belief bias, or a recall bias linked to the intensity/recency of symptoms; (9) heightened physiological arousal; (10) elevated cortical arousal; (11) the presence of brief awakenings; (12) a fault in neuronal circuitry; and (13) there being 2 insomnia subtypes (one with and one without misperception). The best supported resolutions were misperception of sleep as wake, worry, and brief awakenings. A deficit in time estimation ability was not supported. We conclude by proposing several integrative solutions.

7 Clinical Trial Treating Sleep Problems in Young People at Ultra-High Risk of Psychosis: A Feasibility Case Series. 2018

Bradley, Jonathan / Freeman, Daniel / Chadwick, Eleanor / Harvey, Allison G / Mullins, Bradley / Johns, Louise / Sheaves, Bryony / Lennox, Belinda / Broome, Matthew / Waite, Felicity. ·Department of Psychiatry,University of Oxford;Sleep and Circadian Neuroscience Institute,University of Oxford;and Oxford Health NHS Foundation Trust. · Department of Psychiatry,University of Oxford. · Department of Psychology,UC Berkeley. · Oxford Health NHS Foundation Trust. · Department of Psychiatry,University of Oxford;Oxford Health NHS Foundation Trust; and Faculty of Philosophy,University of Oxford. ·Behav Cogn Psychother · Pubmed #29081329.

ABSTRACT: BACKGROUND: Our view is that sleep disturbance may be a contributory causal factor in the development and maintenance of psychotic experiences. A recent series of randomized controlled intervention studies has shown that cognitive-behavioural approaches can improve sleep in people with psychotic experiences. However, the effects of psychological intervention for improving sleep have not been evaluated in young people at ultra-high risk of psychosis. Improving sleep might prevent later transition to a mental health disorder. AIMS: To assess the feasibility and acceptability of an intervention targeting sleep disturbance in young people at ultra-high risk of psychosis. METHOD: Patients were sought from NHS mental health services. Twelve young people at ultra-high risk of psychosis with sleep problems were offered an eight-session adapted CBT intervention for sleep problems. The core treatment techniques were stimulus control, circadian realignment, and regulating day-time activity. Participants were assessed before and after treatment and at a one month follow-up. RESULTS: All eligible patients referred to the study agreed to take part. Eleven patients completed the intervention, and one patient withdrew after two sessions. Of those who completed treatment, the attendance rate was 89% and an average of 7.6 sessions (SD = 0.5) were attended. There were large effect size improvements in sleep. Post-treatment, six patients fell below the recommended cut-off for clinical insomnia. There were also improvements in negative affect and psychotic experiences. CONCLUSION: This uncontrolled feasibility study indicates that treating sleep problems in young people at ultra-high of psychosis is feasible, acceptable, and may be associated with clinical benefits.

8 Article Adapted CBT to Stabilize Sleep on Psychiatric Wards: a Transdiagnostic Treatment Approach. 2018

Sheaves, Bryony / Isham, Louise / Bradley, Jonathan / Espie, Colin / Barrera, Alvaro / Waite, Felicity / Harvey, Allison G / Attard, Caroline / Freeman, Daniel. ·Sleep and Circadian Neuroscience Institute,Department of Psychiatry,University of Oxford,Oxford,UK. · Oxford Health NHS Foundation Trust,Oxford,UK. · Sleep and Circadian Neuroscience,Nuffield Department of Clinical Neurosciences,University of Oxford,Oxford,UK. · University of California,Berkeley,USA. · Berkshire Health NHS Foundation Trust,Berkshire,UK. ·Behav Cogn Psychother · Pubmed #29615140.

ABSTRACT: BACKGROUND: Almost all patients admitted at acute crisis to a psychiatric ward experience clinically significant symptoms of insomnia. Ward environments pose challenges to both sleep and the delivery of therapy. Despite this, there is no description of how to adapt cognitive behavioural therapy (CBT) for insomnia to overcome these challenges. AIMS: (i) To describe the key insomnia presentations observed in the Oxford Ward Sleep Solution (OWLS) trial and (ii) outline key adaptations aimed to increase accessibility and hence effectiveness of CBT for insomnia for a ward setting. METHODS: Trial therapists collaboratively agreed the key insomnia presentations and therapy adaptations based on their individual reflective logs used during the trial. RESULTS: Three key insomnia presentations are outlined. These are used to illustrate the application of 10 CBT for insomnia therapy adaptations. These include use of sleep monitoring watches to engage patients in treatment, stabilizing circadian rhythms, reducing the impact of night-time observations and managing discharge as a sleep challenge. CONCLUSIONS: Whilst inpatient wards bring challenges for sleep and therapy delivery, creative adaptations can increase the accessibility of evidence based CBT for insomnia techniques. This therapy has proven popular with patients.

9 Article Treatment agreement, adherence, and outcome in cognitive behavioral treatments for insomnia. 2018

Dong, Lu / Soehner, Adriane M / Bélanger, Lynda / Morin, Charles M / Harvey, Allison G. ·Department of Psychology, University of California, Berkeley. · Department of Psychiatry, University of Pittsburgh School of Medicine. · Department of Psychology, Université Laval. ·J Consult Clin Psychol · Pubmed #29265834.

ABSTRACT: BACKGROUND: Patient adherence has been identified as an important barrier to the implementation of evidence-based psychological treatments. OBJECTIVE: In cognitive behavioral treatments (CBT) for insomnia, the current study examined (a) the validity of therapist ratings of patient agreement and adherence against an established behavioral measure of adherence, and (b) the relationship between treatment agreement, adherence, and outcome. METHOD: Participants were 188 adults meeting DSM-IV-TR criteria for chronic insomnia who were randomized to receive behavior therapy, cognitive therapy, or CBT for insomnia. Treatment agreement/adherence was measured by (a) weekly therapist ratings of patient agreement and homework completion, and (b) adherence to behavioral strategies (ABS) derived from patient-reported sleep diary. Outcome measures were Insomnia Severity Index and insomnia remission (Insomnia Severity Index <8). RESULTS: Therapist ratings of patient agreement as well as homework completion were significantly associated with sleep diary-derived global ABS. Therapist-rated patient agreement and homework completion as well as global ABS predicted greater insomnia symptoms reduction from pretreatment to posttreatment. Patient agreement also predicted insomnia symptoms reduction from pretreatment to 6-month follow-up. Patient agreement, adherence, and ABS measures during treatment significantly predicted insomnia remission at posttreatment, and all but therapist rating of homework completion predicted remission at 6-month follow-up. CONCLUSIONS: Greater patient agreement and adherence (therapist ratings and ABS) during treatment predicted better treatment outcome. Therapist-rated treatment agreement and adherence correspond well with patient-reported sleep diary-derived adherence measure. These simple, deployable therapist-rated patient agreement and adherence can potentially be useful for treatments for other disorders. (PsycINFO Database Record

10 Article Proinflammatory Cytokines, Mood, and Sleep in Interepisode Bipolar Disorder and Insomnia: A Pilot Study With Implications for Psychosocial Interventions. 2018

Dolsen, Michael R / Soehner, Adriane M / Harvey, Allison G. ·From the Department of Psychology (Dolsen, Harvey), University of California, Berkeley · and Department of Psychiatry (Soehner), University of Pittsburgh School of Medicine, Pennsylvania. ·Psychosom Med · Pubmed #28914726.

ABSTRACT: OBJECTIVE: Proinflammatory cytokines are associated with bipolar disorder (BD), but less is known about how cytokines function during the interepisode period. This study examined cytokines, mood symptoms, and sleep in individuals with interepisode BD with complaints of insomnia. We also investigated the effects of a BD-specific modification of cognitive behavior therapy for insomnia (CBTI-BP) on cytokine levels. METHODS: Twenty-two adults with interepisode BD type I and insomnia were drawn from a subset of a National Institute of Mental Health funded study. Participants were randomly allocated to CBTI-BP (n = 11) or psychoeducation (n = 11). Participants completed a sleep diary, rated self-report measures of mania and depression, and provided samples assayed for interleukin (IL)-6 and tumor necrosis factor soluble receptor 2 (sTNF-R2). RESULTS: IL-6 was associated with mania symptoms (rs = 0.44, p = .041) and total sleep time (rs = -0.49, p = .026). IL-6 was related to depression symptoms at the trend level (rs = 0.43, p = .052). sTNF-R2 was not significantly related to mood or sleep measures. From pretreatment to posttreatment, CBTI-BP compared with psychoeducation was associated with a nonsignificant, large effect size decrease in IL-6 (z = -1.61, p = .13, d = -0.78) and a nonsignificant, small-medium effect size decrease in sTNF-R2 (z = -0.79, p = .44, d = -0.38). CONCLUSIONS: These findings provide preliminary evidence that IL-6 is related to mania symptoms and shorter total sleep time in interepisode BD. A treatment that targets sleep in BD could potentially decrease IL-6 although replication is warranted.

11 Article Mediators and treatment matching in behavior therapy, cognitive therapy and cognitive behavior therapy for chronic insomnia. 2017

Harvey, Allison G / Dong, Lu / Bélanger, Lynda / Morin, Charles M. ·Psychology Department, University of California, Berkeley. · Université Laval. ·J Consult Clin Psychol · Pubmed #28956950.

ABSTRACT: OBJECTIVE: To examine the mediators and the potential of treatment matching to improve outcome for cognitive behavior therapy (CBT) for insomnia. METHOD: Participants were 188 adults (117 women; Mage = 47.4 years, SD = 12.6) meeting the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; text rev.; DSM-IV-TR; American Psychiatric Association [APA], 2000) diagnostic criteria for chronic insomnia (Mduration: 14.5 years, SD: 12.8). Participants were randomized to behavior therapy (BT; n = 63), cognitive therapy (CT; n = 65), or CBT (n = 60). The outcome measure was the Insomnia Severity Index (ISI). Hypothesized BT mediators were sleep-incompatible behaviors, bedtime variability (BTv), risetime variability (RTv) and time in bed (TIB). Hypothesized CT mediators were worry, unhelpful beliefs, and monitoring for sleep-related threat. RESULTS: The behavioral processes mediated outcome for BT but not CT. The cognitive processes mediated outcome in both BT and CT. The subgroup scoring high on both behavioral and cognitive processes had a marginally significant better outcome if they received CBT relative to BT or CT. The subgroup scoring relatively high on behavioral but low on cognitive processes and received BT or CBT did not differ from those who received CT. The subgroup scoring relatively high on cognitive but low on behavioral processes and received CT or CBT did not differ from those who received BT. CONCLUSION: The behavioral mediators were specific to BT relative to CT. The cognitive mediators were significant for both BT and CT outcomes. Patients exhibiting high levels of both behavioral and cognitive processes achieve better outcome if they receive CBT relative to BT or CT alone. (PsycINFO Database Record

12 Article Hypertension with unsatisfactory sleep health (HUSH): study protocol for a randomized controlled trial. 2017

Levenson, Jessica C / Rollman, Bruce L / Ritterband, Lee M / Strollo, Patrick J / Smith, Kenneth J / Yabes, Jonathan G / Moore, Charity G / Harvey, Allison G / Buysse, Daniel J. ·Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara Street, E-1123 TDH, Pittsburgh, PA, 15213, USA. · Division of General Internal Medicine, Center for Behavioral Health and Smart Technology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. · Department of Psychiatry and Neurobehavioral Sciences and Center for Behavioral Health and Technology, University of Virginia School of Medicine, Charlottesville, VA, USA. · VA Pittsburgh Health System, Pittsburgh, PA, USA. · Department of Biostatistics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. · Carolinas HealthCare System, Charlotte, NC, USA. · Department of Psychology, University of California, Berkeley, CA, USA. · Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara Street, E-1123 TDH, Pittsburgh, PA, 15213, USA. buyssedj@upmc.edu. ·Trials · Pubmed #28587609.

ABSTRACT: BACKGROUND: Insomnia is common in primary care medical practices. Although behavioral treatments for insomnia are safe, efficacious, and recommended in practice guidelines, they are not widely-available, and their effects on comorbid medical conditions remain uncertain. We are conducting a pragmatic clinical trial to test the efficacy of two cognitive behavioral treatments for insomnia (Brief Behavioral Treatment for Insomnia (BBTI) and Sleep Healthy Using the Internet (SHUTi)) versus an enhanced usual care condition (EUC). METHODS/DESIGN: The study is a three-arm, parallel group, randomized controlled trial. Participants include 625 adults with hypertension and insomnia, recruited via electronic health records from primary care practices affiliated with a large academic medical center. After screening and baseline assessments, participants are randomized to treatment. BBTI is delivered individually with a live therapist via web-interface/telehealth sessions, while SHUTi is a self-guided, automated, interactive, web-based form of cognitive behavioral therapy for insomnia. Participants in EUC receive an individualized sleep report, educational resources, and an online educational video. Treatment outcomes are measured at 9 weeks, 6 months, and 12 months. The primary outcome is patient-reported sleep disturbances. Secondary outcomes include other self-reported sleep measures, home blood pressure, body mass index, quality of life, health functioning, healthcare utilization, and side effects. DISCUSSION: This randomized clinical trial compares two efficacious insomnia interventions to EUC, and provides a cost-effective and efficient examination of their similarities and differences. The pragmatic orientation of this trial may impact sleep treatment delivery in real world clinical settings and advance the dissemination and implementation of behavioral sleep interventions. TRIAL REGISTRATION: ClinicalTrials.gov (Identifier: NCT02508129 ; Date Registered: July 21, 2015).

13 Article Sleep the night before and after a treatment session: A critical ingredient for treatment adherence? 2017

Dolsen, Michael R / Soehner, Adriane M / Morin, Charles M / Bélanger, Lynda / Walker, Matthew / Harvey, Allison G. ·Department of Psychology, University of California, Berkeley. · Department of Psychiatry, University of Pittsburgh School of Medicine. · École de Psychologie, Université Laval. ·J Consult Clin Psychol · Pubmed #28394172.

ABSTRACT: OBJECTIVE: Sleep prepares key neural structures for next-day learning, and sleep obtained after learning promotes subsequent memory consolidation supporting long-term retention. This study examined whether sleep the night before and after a therapy session predicts aspects of treatment adherence. METHOD: As part of a randomized clinical trial, 188 adults (62.7% female, mean age = 47.5, 80.5% Caucasian) with persistent insomnia received cognitive-behavioral therapy for insomnia. Patients completed a sleep diary before and after treatment sessions. Minutes spent awake during the night (total wake time; TWT) and total sleep time (TST) were used as measures of sleep disturbance. At each treatment session, therapists rated participant understanding of the session and homework compliance from the previous session. RESULTS: Compared to longer TWT, before session shorter TWT was associated with increased treatment understanding the next day. After session shorter TWT was also associated with increased understanding, but not homework compliance the subsequent session compared to participants with longer TWT. Similar results were obtained for TST. CONCLUSIONS: Improving sleep may benefit patient adherence to treatment. Sleep may influence processes related to initial learning and subsequent consolidation of treatment information. Future studies should examine whether improved sleep within other psychiatric disorders is also an ingredient to the successful outcome of psychosocial interventions. (PsycINFO Database Record

14 Article Life-time history of insomnia and hypersomnia symptoms as correlates of alcohol, cocaine and heroin use and relapse among adults seeking substance use treatment in the United States from 1991 to 1994. 2017

Dolsen, Michael R / Harvey, Allison G. ·Department of Psychology, University of California, Berkeley, USA. ·Addiction · Pubmed #28127809.

ABSTRACT: AIMS: To examine the association between a life-time history of insomnia and hypersomnia compared with no sleep disturbance and substance use patterns and amounts before and after a substance use treatment episode. DESIGN: Secondary analysis of data from the Drug Abuse Treatment Outcome Studies conducted from 1991 to 1994. SETTING: Data were collected at 96 substance use treatment programs in 11 United States cities, including short-term in-patient, long-term residential, methadone maintenance and out-patient drug-free treatment modalities. PARTICIPANTS: Study samples included 7168 adults at treatment entry and 2965 at 12 months post-treatment entry whose primary substance use at entry was alcohol (14.7%), cocaine (62.7%) or heroin (22.6%). MEASUREMENTS: Life-time history of insomnia and hypersomnia was assessed via self-report. Type and frequency of substance use were assessed at treatment entry. Substance use was also assessed 12 months following treatment completion. Associations were examined using linear and logistic regression with age, sex, race, education level, depression history, treatment modality and in-treatment substance use as covariates. FINDINGS: Life-time history of insomnia, hypersomnia, both or neither was reported by 26.3, 9.5, 28.0 and 36.2% of participants, respectively. Compared with no sleep disturbance, life-time insomnia and hypersomnia were associated at treatment entry with unique substance use patterns and a higher frequency of any substance use (P < 0.001). All types of sleep disturbance were associated with higher rates of cocaine use at 12-month post-entry (odds ratios: 1.30-1.57). CONCLUSIONS: There is evidence of an adverse association between substance use and sleep disturbance including higher frequency of all substance use before substance abuse treatment and higher rates of cocaine use after a treatment episode.

15 Article The association between insomnia-related sleep disruptions and cognitive dysfunction during the inter-episode phase of bipolar disorder. 2017

Kanady, Jennifer C / Soehner, Adriane M / Klein, Alexandra B / Harvey, Allison G. ·Department of Psychology, University of California, Berkeley, 3321 Tolman Hall, 94720 Berkeley, CA, USA. · Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 Ohara St, 15213 Pittsburgh, PA, USA. · VA Boston Healthcare System, 150 S. Huntington Ave. Boston, 02130 MA, USA. · Department of Psychology, University of California, Berkeley, 3321 Tolman Hall, 94720 Berkeley, CA, USA. Electronic address: aharvey@berkeley.edu. ·J Psychiatr Res · Pubmed #28088728.

ABSTRACT: Sleep disturbance and cognitive dysfunction are two domains of impairment during inter-episode bipolar disorder. Despite evidence demonstrating the importance of sleep for cognition in healthy and sleep-disordered samples, this link has been minimally examined in bipolar disorder. The present study tested the association between insomnia-related sleep disruptions and cognitive dysfunction during inter-episode bipolar disorder. Forty-seven participants with bipolar disorder and a comorbid insomnia diagnosis (BD-Insomnia) and 19 participants with bipolar disorder without sleep disturbance in the last six months (BD-Control) participated in the study. Two domains of cognition were assessed: working memory and verbal learning. Insomnia-related sleep disruptions were assessed both categorically (i.e., insomnia diagnosis) and dimensionally (i.e., total wake time, total sleep time, total wake time variability, and total sleep time variability). Hierarchical linear regressions, adjusting for participant age, demonstrated that insomnia diagnosis did not have an independent or interactive effect on cognition. However, regardless of insomnia diagnosis, greater total sleep time variability predicted poorer working memory and verbal learning performance. Further, following sleep treatment, a reduction in total wake time predicted improved working memory performance and a reduction in total sleep time variability predicted improved verbal learning performance. These findings raise the possibility that sleep disturbance may contribute to cognitive dysfunction in bipolar disorder and highlight the importance of treating sleep disturbance in bipolar disorder.

16 Article Impact of comorbid anxiety and depressive disorders on treatment response to cognitive behavior therapy for insomnia. 2016

Bélanger, Lynda / Harvey, Allison G / Fortier-Brochu, Émilie / Beaulieu-Bonneau, Simon / Eidelman, Polina / Talbot, Lisa / Ivers, Hans / Hein, Kerrie / Lamy, Manon / Soehner, Adriane M / Mérette, Chantal / Morin, Charles M. ·École de psychologie, Université Laval and Centre Hospitalier Universitaire de Québec. · Department of Psychology, University of California, Berkeley. · École de psychologie, Université Laval and Institut Universitaire en Santé Mentale de Québec. · Department of Psychiatry, School of Medicine, University of Pittsburgh. · Département de psychiatrie et de neurosciences, Université Laval and Centre de recherche de l'Institut Universitaire en Santé Mentale de Québec. · École de psychologie, Université Laval and Centre de recherche de l'Institut Universitaire en Santé Mentale de Québec. ·J Consult Clin Psychol · Pubmed #26963600.

ABSTRACT: OBJECTIVE: To evaluate the impact of comorbid anxiety or depressive disorders on treatment response to cognitive-behavior therapy (CBT) for insomnia, behavior therapy (BT), or cognitive therapy (CT). METHOD: Participants were 188 adults (117 women; Mage = 47.4 years) with chronic insomnia, including 45 also presenting a comorbid anxiety or mild to moderate depressive disorder. They were randomized to BT (n = 63), CT (n = 65), or CBT (n = 60). Outcome measures were the proportion of treatment responders (decrease of ≥8 points on the Insomnia Severity Index; ISI) and remissions (ISI score < 8) and depression and anxiety symptoms. RESULTS: Proportion of treatment responders and remitters in the CBT condition was not significantly different between the subgroups with and without comorbidity. However, the proportion of responders was lower in the comorbidity subgroup compared to those without comorbidity in both the BT (34.4% vs. 81.6%; p = .007) and CT (23.6% vs. 57.6%; p = .02) alone conditions, although remission rates and prepost ISI change scores were not. Pre to post change scores on the depression (-10.6 vs. -3.9; p < .001) and anxiety measures (-9.2 vs. -2.5; p = .01) were significantly greater in the comorbidity subgroup relative to the subgroup without comorbidity but only for those treated with the full CBT; no difference was found for those treated with either BT or CT alone. CONCLUSIONS: The presence of a comorbid anxiety or mild to moderate depressive disorder did not reduce the efficacy of CBT for insomnia, but it did for its single BT and CT components when used alone. (PsycINFO Database Record

17 Article Change in Dysfunctional Beliefs About Sleep in Behavior Therapy, Cognitive Therapy, and Cognitive-Behavioral Therapy for Insomnia. 2016

Eidelman, Polina / Talbot, Lisa / Ivers, Hans / Bélanger, Lynda / Morin, Charles M / Harvey, Allison G. ·Cognitive Behavior Therapy and Science Center. · San Francisco VA Medical Center. · Université Laval. · University of California, Berkeley. Electronic address: aharvey@berkeley.edu. ·Behav Ther · Pubmed #26763501.

ABSTRACT: As part of a larger randomized controlled trial, 188 participants were randomized to behavior therapy (BT), cognitive therapy (CT), or cognitive-behavioral therapy (CBT) for insomnia. The aims of this study were threefold: (a) to determine whether change in dysfunctional beliefs about sleep was related to change in sleep, insomnia symptoms, and impairment following treatment; (b) to determine whether BT, CT, and CBT differ in their effects on dysfunctional beliefs; and (c) to determine whether the treatments differ in their effects on particular kinds of dysfunctional beliefs. Beliefs, sleep, insomnia symptoms, and sleep-related psychosocial impairment were assessed at pretreatment, posttreatment, and 6- and 12-month follow-up. Greater change in dysfunctional beliefs occurring over the course of BT, CT, or CBT was associated with greater improvement in insomnia symptoms and impairment at posttreatment and both follow-ups. All groups experienced a significant decrease in dysfunctional beliefs during treatment, which were sustained through 6- and 12-month follow-up. Compared with the BT group, a greater proportion of participants in the CT and/or CBT groups endorsed dysfunctional beliefs below a level considered clinically significant at posttreatment and 12-month follow-up. The results demonstrate the importance of targeting dysfunctional beliefs in insomnia treatment, suggest that beliefs may be significantly modified with BT alone, and indicate that cognitive interventions may be particularly powerful in enhancing belief change.

18 Article Cognitive-behavioral treatment of insomnia and depression in adolescents: A pilot randomized trial. 2015

Clarke, Greg / McGlinchey, Eleanor L / Hein, Kerrie / Gullion, Christina M / Dickerson, John F / Leo, Michael C / Harvey, Allison G. ·Kaiser Permanente Center for Health Research, 3800 N. Interstate Blvd, Portland, OR 97227, USA. Electronic address: greg.clarke@kpchr.org. · University of California at Berkeley (UCB) Golden Bear Sleep and Mood Research Clinic, Department of Psychology, University of California, 3210 Tolman Hall #1650, Berkeley, CA 94720-1650, USA. · Kaiser Permanente Center for Health Research, 3800 N. Interstate Blvd, Portland, OR 97227, USA. ·Behav Res Ther · Pubmed #25917009.

ABSTRACT: We tested whether augmenting conventional depression treatment in youth by treating sleep issues with cognitive behavioral therapy for insomnia (CBT-I) improved depression outcomes. We randomized youth 12-20 years of age to 10 weekly sessions of a sleep hygiene control condition (SH) combined with CBT for depression (CBT-D) (n = 20), or an experimental condition consisting of CBT-I combined with CBT-D (n = 21). We assessed outcomes through 26 weeks of follow-up and found medium-large effects favoring the experimental CBT-I arm on some sleep outcomes (actigraphy total sleep time and Insomnia Severity Index "caseness") and depression outcomes (higher percentage recovered, faster time to recovery), but little effect on other measures. Total sleep time improved by 99 min from baseline to week 12 in the CBT-I arm, but not in the SH arm. In addition, our pilot yielded important products to facilitate future studies: the youth-adapted CBT-I program; the study protocol; estimates of recruitment, retention, and attrition; and performance and parameters of candidate outcome measures. ClinicalTrials.gov Identifier NCT00949689.

19 Article Later emotional and behavioral problems associated with sleep problems in toddlers: a longitudinal study. 2015

Sivertsen, Børge / Harvey, Allison G / Reichborn-Kjennerud, Ted / Torgersen, Leila / Ystrom, Eivind / Hysing, Mari. ·Division of Mental Health, Norwegian Institute of Public Health, Bergen2Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Bergen, Norway 3Department of Psychiatry, Helse Fonna HF, Haugesund, Norway. · Department of Psychology, University of California, Berkeley. · Division of Mental Health, Norwegian Institute of Public Health, Bergen5Institute of Psychiatry, University of Oslo, Oslo, Norway. · Division of Mental Health, Norwegian Institute of Public Health, Bergen. · Division of Mental Health, Norwegian Institute of Public Health, Bergen6Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway. · Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Bergen, Norway. ·JAMA Pediatr · Pubmed #25867179.

ABSTRACT: IMPORTANCE: Childhood sleep problems have been linked to a range of adverse health outcomes, but there is limited knowledge as to the temporal association between sleep problems and subsequent emotional and behavioral problems in young children. OBJECTIVE: To examine whether sleep problems in toddlers aged 18 months are related to both concurrent and subsequent emotional and behavioral problems in preschool children aged 5 years. DESIGN, SETTING, AND PARTICIPANTS: A large population-based longitudinal study was conducted in September 2014 using data from the Norwegian Mother and Child Cohort Study conducted at the Norwegian Institute of Public Health from June 1, 1999, to December 31, 2008. A total of 32 662 children or pregnancies were included. EXPOSURES: Sleep was assessed by mother-reported child sleep duration and nocturnal awakenings. MAIN OUTCOMES AND MEASURES: Emotional and behavioral problems were measured with items from the Child Behavior Checklist and operationalized according to recommended clinical cutoffs, corresponding to T scores of greater than 65 (93rd percentile). Risk ratios (RRs) were calculated using negative binomial regression, controlling for emotional and behavioral problems at 18 months and other relevant covariates. RESULTS: Short sleep duration (≤10 hours) in 556 children (1.7%) and frequent nocturnal awakenings (≥3 times) in 1033 children (3.2%) at 18 months significantly predicted both concurrent and later incidence of emotional and behavioral problems at 5 years. The longitudinal RRs were generally larger for internalizing problems, with adjusted RRs of 1.59 (95% CI, 1.23-2.08) for both short sleep duration and 1.57 (95% CI, 1.28-1.93) for nocturnal awakenings; RRs for externalizing problems were 1.77 (95% CI, 1.37-2.30) and 1.25 (95% CI, 1.00-1.58), respectively. Additional adjustment for emotional and behavioral problems at 18 months slightly reduced the strength of these associations, and all RRs remained significant in the fully adjusted models. CONCLUSIONS AND RELEVANCE: Early sleep problems predict later development of emotional and behavioral problems. Intervention studies are needed to examine whether sleep programs targeting early childhood may avert the onset of later adverse outcomes.

20 Article Treating insomnia improves mood state, sleep, and functioning in bipolar disorder: a pilot randomized controlled trial. 2015

Harvey, Allison G / Soehner, Adriane M / Kaplan, Kate A / Hein, Kerrie / Lee, Jason / Kanady, Jennifer / Li, Descartes / Rabe-Hesketh, Sophia / Ketter, Terence A / Neylan, Thomas C / Buysse, Daniel J. ·Department of Psychology, University of California, Berkeley. · Department of Psychiatry, School of Medicine, University of California, San Francisco. · Graduate School of Education, University of California, Berkeley. · Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University. · Department of Psychiatry, University of Pittsburgh. ·J Consult Clin Psychol · Pubmed #25622197.

ABSTRACT: OBJECTIVE: To determine if a treatment for interepisode bipolar disorder I patients with insomnia improves mood state, sleep, and functioning. METHOD: Alongside psychiatric care, interepisode bipolar disorder I participants with insomnia were randomly allocated to a bipolar disorder-specific modification of cognitive behavior therapy for insomnia (CBTI-BP; n = 30) or psychoeducation (PE; n = 28) as a comparison condition. Outcomes were assessed at baseline, the end of 8 sessions of treatment, and 6 months later. This pilot was conducted to determine initial feasibility and generate effect size estimates. RESULTS: During the 6-month follow-up, the CBTI-BP group had fewer days in a bipolar episode relative to the PE group (3.3 days vs. 25.5 days). The CBTI-BP group also experienced a significantly lower hypomania/mania relapse rate (4.6% vs. 31.6%) and a marginally lower overall mood episode relapse rate (13.6% vs. 42.1%) compared with the PE group. Relative to PE, CBTI-BP reduced insomnia severity and led to higher rates of insomnia remission at posttreatment and marginally higher rates at 6 months. Both CBTI-BP and PE showed statistically significant improvement on selected sleep and functional impairment measures. The effects of treatment were well sustained through follow-up for most outcomes, although some decline on secondary sleep benefits was observed. CONCLUSIONS: CBTI-BP was associated with reduced risk of mood episode relapse and improved sleep and functioning on certain outcomes in bipolar disorder. Hence, sleep disturbance appears to be an important pathway contributing to bipolar disorder. The need to develop bipolar disorder-specific sleep diary scoring standards is highlighted.

21 Article Memory for therapy in bipolar disorder and comorbid insomnia. 2015

Lee, Jason Y / Harvey, Allison G. ·Department of Psychology, University of California. ·J Consult Clin Psychol · Pubmed #25222800.

ABSTRACT: OBJECTIVE: To examine the extent to which patients recall the contents of therapy from 1 session to the next and to determine whether recall is associated with treatment outcome. METHOD: Thirty interepisode individuals with bipolar disorder and comorbid insomnia (ages 21-62 years, 56.7% women, 56.7% Caucasian) participated in a randomized controlled trial of psychotherapies. Patients received either cognitive behavior therapy for insomnia (CBTI-BP; n = 17) or psychoeducation (PE; n = 13). At the beginning of each weekly session, patients freely recalled as many therapy points (i.e., distinct ideas, principles, and experiences) as they could from their previous session. After each session, therapists recorded a list of all therapy points delivered. Treatment outcome was measured via the Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index, Patient-Reported Outcome Measurement Info System-Sleep, and Quality of Life-Sleep (QOL-Sleep), administered pre- and posttreatment, and treatment evaluation questions administered posttreatment. RESULTS: Patients recalled 19.6% to 36.9% of therapy points listed by therapists. Raw numbers of therapy points recalled were positively correlated with reductions in ISI scores and gains in QOL-Sleep and with most treatment evaluation questions. Percentages of therapy points recalled were positively correlated with gains in QOL-Sleep but with no other sleep outcome measures or any of the treatment evaluation questions. Patients in CBTI-BP recalled more therapy points than did those in PE but did not differ in the percentages of points recalled. CONCLUSIONS: Memory for therapy is poor. The amount of content recalled is positively associated with treatment outcome. Enhancing memory for therapy might play a key role in improving treatment outcome.

22 Article Insomnia before and after treatment for anxiety and depression. 2014

Mason, Elizabeth C / Harvey, Allison G. ·Clinical Research Unit for Anxiety and Depression (CRUfAD), University of New South Wales at St Vincent׳s Hospital, Level 4, O׳Brien Centre, 394-404 Victoria Street, Darlinghurst, NSW 2010, Australia. Electronic address: emason@unsw.edu.au. · Department of Psychology, University of California, Berkeley, 3321 Tolman Hall, Berkeley 94720, USA. ·J Affect Disord · Pubmed #25108278.

ABSTRACT: BACKGROUND: Insomnia increases the likelihood of developing a mood or anxiety disorder. Moreover, symptoms of anxiety and depression, such as worry and rumination, contribute to insomnia. Given these relationships, there is a need to delineate how these disorders respond to treatment when they are comorbid. METHODS: 266 individuals presenting for anxiety and/or depression symptoms participated in this study in which symptoms of insomnia, anxiety, depression, disability, and sleep length were assessed. 102 of these patients were treated with internet-based cognitive behavioral therapy (iCBT) for anxiety and/or depression and 61 completed the treatment. Pre- to post-treatment symptom changes were examined in this subset. RESULTS: Insomnia, as measured by the Insomnia Severity Index, was evident in 40% of the patients. Individuals with insomnia reported more severe symptoms of anxiety and depression than individuals without insomnia. iCBT focused on anxiety and/or depression was associated with reductions in symptoms of insomnia, anxiety, depression, and disability. Total sleep time did not change over treatment. LIMITATIONS: As the data were collected in routine care, there was no control group and no longer term follow-up assessment. CONCLUSIONS: These findings highlight the importance of insomnia across anxiety and depressive disorders. They further demonstrate that treatment for anxiety and/or depression appears to improve comorbid insomnia symptoms, though may be ineffective in changing sleep duration.

23 Article Prevalence and clinical correlates of co-occurring insomnia and hypersomnia symptoms in depression. 2014

Soehner, Adriane M / Kaplan, Katherine A / Harvey, Allison G. ·Department of Psychology, University of California, Berkeley, USA; Department of Psychiatry, University of Pittsburgh Medical Center, USA. · Department of Psychiatry & Behavioral Science, Stanford University Medical Center, USA. · Department of Psychology, University of California, Berkeley, USA. Electronic address: aharvey@berkeley.edu. ·J Affect Disord · Pubmed #24953480.

ABSTRACT: BACKGROUND: The aim was to examine the prevalence and consequences of co-occurring insomnia and hypersomnia symptoms in depressed adults drawn from a representative sample of the U.S. population. METHOD: Data from 687 National Comorbidity Survey Replication (NCS-R) respondents meeting criteria for a major depressive episode (MDE) in the past year were included. Respondents completed clinical interviews that assessed 12-month DSM-IV disorders, impairment, mental health treatment, and depressive symptom severity. Outcomes were compared between respondents who experienced insomnia symptoms-only (N=404), hypersomnia symptoms-only (N=44), both insomnia and hypersomnia symptoms (N=184) and no sleep problems (N=55) during an MDE. RESULTS: Insomnia and hypersomnia symptoms co-occurred in 27.7% of respondents with past-year MDEs, most frequently in bipolar spectrum disorders and major depressive disorder with dysthymia. Similar to the insomnia-only group, respondents with co-occurring sleep disturbances had more severe depression, and higher rates of past-year impulse control disorders and suicide planning. Similar to the hypersomnia-only group, respondents with co-occurring sleep disturbances had higher rates of past-year drug use disorders and suicide attempts. Compared to the insomnia-only and no sleep problem groups, respondents with both sleep disturbances were more frequently in mental health treatment, seeing a general practitioner, and taking antidepressants. LIMITATIONS: The NCS-R is cross-sectional and did not evaluate sleep disorder diagnoses. CONCLUSIONS: Co-occurring insomnia and hypersomnia symptoms were associated with a more severe MDE. Further research is warranted to more fully understand the joint presentation of insomnia and hypersomnia in depression.

24 Article Comparative efficacy of behavior therapy, cognitive therapy, and cognitive behavior therapy for chronic insomnia: a randomized controlled trial. 2014

Harvey, Allison G / Bélanger, Lynda / Talbot, Lisa / Eidelman, Polina / Beaulieu-Bonneau, Simon / Fortier-Brochu, Émilie / Ivers, Hans / Lamy, Manon / Hein, Kerrie / Soehner, Adriane M / Mérette, Chantal / Morin, Charles M. ·Department of Psychology, University of California, Berkeley. · Department of Psychology, Université Laval. · Department of Psychiatry, University of California, San Francisco. · Cognitive Behavior Therapy and Science Center. · Department of Psychiatry, University of Pittsburgh Medical Center. ·J Consult Clin Psychol · Pubmed #24865869.

ABSTRACT: OBJECTIVE: To examine the unique contribution of behavior therapy (BT) and cognitive therapy (CT) relative to the full cognitive behavior therapy (CBT) for persistent insomnia. METHOD: Participants were 188 adults (117 women; M age = 47.4 years, SD = 12.6) with persistent insomnia (average of 14.5 years duration). They were randomized to 8 weekly, individual sessions consisting of BT (n = 63), CT (n = 65), or CBT (n = 60). RESULTS: Full CBT was associated with greatest improvements, the improvements associated with BT were faster but not as sustained and the improvements associated with CT were slower and sustained. The proportion of treatment responders was significantly higher in the CBT (67.3%) and BT (67.4%) relative to CT (42.4%) groups at post treatment, while 6 months later CT made significant further gains (62.3%), BT had significant loss (44.4%), and CBT retained its initial response (67.6%). Remission rates followed a similar trajectory, with higher remission rates at post treatment in CBT (57.3%) relative to CT (30.8%), with BT falling in between (39.4%); CT made further gains from post treatment to follow up (30.9% to 51.6%). All 3 therapies produced improvements of daytime functioning at both post treatment and follow up, with few differential changes across groups. CONCLUSIONS: Full CBT is the treatment of choice. Both BT and CT are effective, with a more rapid effect for BT and a delayed action for CT. These different trajectories of changes provide unique insights into the process of behavior change via behavioral versus cognitive routes.

25 Article Cognitive processes and their association with persistence and remission of insomnia: findings from a longitudinal study in the general population. 2014

Norell-Clarke, Annika / Jansson-Fröjmark, Markus / Tillfors, Maria / Harvey, Allison G / Linton, Steven J. ·School of Law, Psychology, and Social Work, Örebro University, SE-701 82 Örebro, Sweden. Electronic address: annika.norell@oru.se. · School of Law, Psychology, and Social Work, Örebro University, SE-701 82 Örebro, Sweden; Department of Psychology, Stockholm University, SE-106 91 Stockholm, Sweden. · School of Law, Psychology, and Social Work, Örebro University, SE-701 82 Örebro, Sweden. · Department of Psychology, University of California, 3210 Tolman Hall, Berkeley, CA 94720-1650, USA. ·Behav Res Ther · Pubmed #24513668.

ABSTRACT: AIM: Insomnia is a common health problem that affects about 10% of the population. The purpose of this investigation was to examine the association between cognitive processes and the persistence and remission from insomnia in the general population. METHODS: In a longitudinal design, 2333 participants completed a survey on night time and daytime symptoms, and cognitive processes. Follow-up surveys were sent out six months and 18 months after the first assessment. Participants were categorised as having persistent insomnia, being in remission from insomnia or being a normal sleeper. RESULTS: Cognitive processes distinguished between people with persistent insomnia and normal sleepers. Specifically, worry, dysfunctional beliefs, somatic arousal, selective attention and monitoring, and safety behaviours increased the likelihood of reporting persistent insomnia rather than normal sleep. For people with insomnia, more worry about sleep at baseline predicted persistent insomnia but not remission later on. Lower selective attention and monitoring, and use of safety behaviours over time increased the likelihood of remission from insomnia. In general, these results remained, when psychiatric symptoms and medical complaints were added to the models. CONCLUSIONS: The findings support that certain cognitive processes may be associated with persistence and remission of insomnia. Clinical implications are discussed.

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